June 9, 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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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
All right, Southeast sexist Internet radio listeners, Welcome to another
edition of the Doctor Levine Medical Hour. I am Doctor Levine,
your routine weekly host. I'm live at the studios of
KLVI here in Beaumont, Texas, cross the street from Parkdale Mall,
(00:20):
taking your phone calls, answering questions about healthcare and health
questions to try and help you stay alive, healthy as
long as possible, because that can be difficult. Phone lines
are open eight nine six klv I won eight hundred
three three zero kov I. We'd love to hear from
you and answer your question and see if we can
(00:44):
get you some information, make you feel better, help you
figure out what's good for you, what's good for your family,
as there's so much information and misinformation out there for
a good reason. I mean, I remember when I first
started this journey becoming a medical professional. We didn't really
(01:04):
share other than you're a practitioner, telling you and talking
with you. We didn't really share a lot of information,
your own information with you so that you can digest
that better. It was sort of what we call point
of care sharing of information, where you're in front of
(01:24):
your healthcare provider and you're sort of talking about your situation,
and you're supposed to remember everything that they say, you know,
when you're sick and you're on pain meds and you're
throwing up, and you're just supposed to remember everything. And
you know, when you're sick, you don't really want to
receive information and you just want to feel better. Y'all
(01:47):
sort of focused on the pain. It's difficult to remember
all these things that your doctor a healthcare professional taught
you or is telling you what to do to feel better.
And the system has gotten a lot better at sharing
that information with you, especially with the use of what
they call electronic medical records as well as these sort
(02:12):
of patient portals where you get a password or a
code word and you can access some of your information
that is available. A lot of times it's lab work
and upcoming appointments or past appointments, or even messaging between
you and your healthcare provider. The healthcare provider sending you messages,
(02:35):
or you sending your healthcare provider, or even the office
of your healthcare provider sending them messages, getting your appointments,
maybe getting some updates, just a better way to communicate
and share that information. So the whole system in general
has gotten to that point where a lot of the
(02:57):
information medical information is available to you. When I came
out and became a physician, that information was somewhat exclusive
to healthcare providers. You know, we had drinking my morning
coffee decaf can't tolerate the caffeine anymore, can sometimes cause palpitations,
(03:21):
and I'm drink coffee throughout the day, typically had to
go decaf on you guys. It still still has a
little caffeine in it, but certainly not as much as
the real thing. But back to when I first came out,
a lot of that information was exclusive to the practitioner,
meaning the average person just didn't have access to a
(03:45):
lot of medical info and medical knowledge, and so everything
sort of came from the physician. And now we have
what we call physician extenders and those practitioners physician assistants.
Their presence has grown each year. I don't see that
slowing down. They provide a necessary service in the healthcare community,
(04:08):
a lot of different avenues that they found themselves in
just helping out and doing some good work. But the
information was just more exclusive and limited, and patients were
really in the dark about a lot of what was
going on and what was happening is mysterious. But now
(04:30):
that the floodgates of information have opened and they're now
accessible to a lot of times, information gets to the
patient faster than it gets to a practitioner, and we're
sort of sometimes behind. Patients come in with their news
or events or twenty four updates with what's going on
(04:52):
and bring it to us to sort of talk about it,
and a lot of times we've never heard about it.
I mean, because there's so much information, every practitioner sort
of has their source of information that they go to. Personally,
I listen to the satellite radio. They have a doctor's
channel on the satellite radio Serious XM. I've had the
(05:16):
satellite radio for many years, let's say fifteen years I've
had that. I love it, and they have a doctor
channel on there, and that's primarily what I listen to.
When I'm in the car or I'm going out of town,
I listen to that station, and that's where I get
a lot of my information just listening to other doctors
talk about a lot of these topics and what's going
(05:39):
on in their lives and what's new in healthcare. So
everybody has their source Leonard from Houston, what's up?
Speaker 2 (05:48):
About six weeks ago? But I burned the bottle on
my feet and they blister and it popped, and they've
been leaking ever since. The bleeding is stop, but I'm
still getting that pushed stuff out of them. Change the
bandage just two or three times a day, neo spoor
and that kind of stuff. Is there anything else I
should be doing to help speed that recovery?
Speaker 1 (06:11):
I mean no, I don't think so. Most of the time,
these superficial wounds, which it sounds like your injury was
a sort of a stage one or a Grade one
injury to the skin, which again it can cause the
top layer to what we call slough off or die,
and it exposes the more deeper layers of the skin layer.
(06:35):
Because the skin does have several layers, even though it's
super thin, it has different layers and each layer has
different responsibilities. Most of the time with those sort of
stage one are Grade one lesions, you just have to
keep it clean and do some wound therapy. You're correct,
(06:56):
I mean sort of keep the area clean. If there's
any dead skin in any drainage, sort of dry that
up and remove that. There's a lot of products over
the counter that patients have access to where they can
sort of do their own wound therapy. There's podcasts and
sort of websites you can go to for basic wound therapy.
I was talking about that this morning. And normally, under
(07:19):
normal circumstances, it gets better over time. But Leonard, I
know you have diabetes, and we care a lot about
foot care for diabetic patients, and certainly if you're wound
is not improving, then probably you need to go to
a professional, probably a peddiet since it's dealing with your foot.
Speaker 2 (07:41):
I've better see the foot doctor and he's you know,
I'm doing what he says. It just seems like it's
taken a long time. It is getting better, and I
can tell that, but it just seems like it's taken
a long time.
Speaker 1 (07:55):
Well, Leonard, yeah, absolutely, and it's one of the aspects
unfortunately of getting older. You've called over the years. I
know you're up in age and you do have diabetes,
and the numbers you give me says you're under control.
But the body just doesn't heal as rapidly when you're older.
It just doesn't. And it's a rude awakening. I'm sorry.
(08:18):
And I try to explain that as much as I
can on this show. Is your body just slows down.
It doesn't do very well with acute injury. And so yeah,
that wound might take a month two months to heal,
whereas if you were in your twenties it would heal
within a couple of weeks. That's just how the body works.
But like you said, it sounds like it's going in
(08:39):
the right direction.
Speaker 2 (08:41):
Good now, thanks Greg.
Speaker 1 (08:42):
Guys all right, Leonard, I appreciate that. Have a good weekend.
It's out of the heat. I have this something that
I mean, I've just noticed as a doctor helping elderly
patients and being in the hospital every day being an
ICU over the years twenty years, my well wife and
(09:08):
I realized that we've been in practice for almost nineteen years.
We're like, wow, it went by fast, super fast. Anyway,
as we get older, that aging process, I know, we
hate it, right that as we get older, were supposed
to have be live in the golden years, right, retire
and have fun and the sunset and just everything is gravy.
(09:34):
But man, it's not. For a lot of people. Just
as you get older, things to actually start breaking down
and you really, really, really have to understand that issue.
And if you don't want to break down, you want
to be healthy, you don't want to be in the
doctor's office. You really have to put some effort into
not abusing your body and taking care of your body.
(09:56):
You really got to do it. And if you don't,
then yeah, you more than likely going to spend a
lot of your time at the doctor's office. You know, ill,
chronically ill, taking prescription medications, going to a bunch of
doctor visits. Just your whole life is sort of consumed
(10:16):
by being ill, and chronically ill that is. And I
can tell you it's really not fun. It limits your
ability to travel, It limits your dietary issues. You just
can't eat this, can't drink that, and you feel bad
all the time. It's really no fun. And the one
(10:37):
thing is, like i've Leonard has we were talking about,
is the body just doesn't heal as well. And that
goes for as I've mentioned on this show, acute to
medical trauma, which is sort of what I call a
lot of the things that happen to elderly patients as
they get older, a stroke, a heart attack, and acute infection,
(10:59):
which we've called sepsis, it could be a bladder infection,
and skin infection, lung infection, we see that, but there's
a whole host of other infections that happens when you
get older. They just happen. And again a couple of
reasons why that is is the immune system just doesn't
(11:20):
work as well. We were talking about the skin system
and how it heals, but the immune system slows down too,
which we promote vaccines all the time, and I know
you guys get sick of me saying that and recommending it,
but you have to understand what's happening in the background
as you get up into your fifties, sixties, seventies, eighties.
(11:42):
I mean, it just keeps going. It's programmed into all
of us, to our system to sort of start auto
shut down mode, if you will, where all the systems
will just sort of start to shut down. They don't
work as well and are vulnerable to any sort of
(12:03):
acute illness or crises that occurs to us. And when
it happens, sometimes it's too much for the body to tolerate,
which you know, if you're elderly and you have friends
and family, you know so and so that live down
the street, are a girlfriend that you talk to or
a family member that is up in age. They get
(12:23):
in the hospital and things don't go well and they
might not ever leave the hospital, which, again, as a
medical doctor, I understand that completely because again I've done
it for so many years, I've seen it happen in
front of my eyes. Is again, you get a sepsis
episode from your inn atract infection or let's just say pneumonia,
(12:47):
and the pneumonia is sort of overwhelming. You have some
heart problems, some kidney problems that you've been taking your medicines.
You've been going to your kidney doctor and your heart doctor,
and everything is fine as long as you don't you're
not sick. Right, there's sometimes a false sense of security
(13:07):
when you go to your doctor and he's like app
everything or she is, you're doing good, We're not going
to change anything, and we walk out feeling great, and
I think that's all wonderful that you're doing your part.
But you could come down with a cute lung infection
blad infection, and you're in the hospital two weeks later,
you know, fighting for your life. And that's because as
(13:31):
long as as long as there's no acute illness and
you're sort of what we call steady state. There's no crises,
there's no trauma. Everything's good. Your body can tolerate that.
You can take your edge and go to sleep, eat,
everything's great. But once you get some trauma in there,
some stress on the human body, and you're stressing that
(13:52):
heart out and those kidneys and that liver and that brain,
the nervous system. How many times maybe you've been to
the hospital to visit your mother or your wife, your husband,
and he's confused, he doesn't know who you are. He's
pulling out his ivs, he won't go to sleep, he's
running down the hall with no clothes on. I mean,
(14:14):
this stuff happens right every day in the hospital. I
mean it's amazing to me, even in the emergency department.
If you've ever been in a modern emergency department, you
see all the things that are happening in front of you,
and it happens every day. And it's sort of shocking
to me that this stuff is happening every day, but
(14:34):
it is. And you really really understand that. Again, as
we get older, just the body is not built for stress.
As we get a to go get those vaccines, right, flu, pneumonia, shingles,
covid are as. We go get him today if you
(14:55):
haven't had him, phone line to open eight nine to
six klv I when in one hundred three threes zero kovy.
I'll be back in two minutes. Oh right, Welcome back
(15:15):
to the Doctoravie. Medical phone lines are open eight nine
six kov I one hundred and three to three zero
ko v I talking about various topics this morning, getting
those vaccines and staying out of the hospital, as well
as all the information that patients are getting now, I
mean it's god, I mean an enormous amount. I mean,
(15:38):
every step of the way, you're getting all this paperwork
put in front of you about all sorts of things.
And I think it's a good thing, to be honest
with you, it really is. I mean I sort of
chuckle at when I first came out, we just sort
of talked to patients and maybe the most paperwork they
would get is a receipt and then maybe some paper
(16:01):
prescriptions for the medications that they were supposed to get, right,
and sometimes you walk out a bunch of prescriptions. But now,
because of various modern conveniences and advancements with electronic medical records.
A lot of that information is more easily shared, and
the understanding is that it allows the patient to understand
(16:25):
better what is going wrong with them, and what the
thoughts of the doctors and the healthcare providers, and just
documenting more clearly the diagnoses, where they went, medications are taking.
I mean, all of that stuff, in my opinion, is
useful information, very useful information for everyone. That would be
(16:49):
all the providers as well as the patients themselves. Some
patients are better at documenting everything that happens with them.
You see the wifer, it's it's mainly mainly the wife, right. Guys,
for whatever reason, don't get into a lot of that.
That's just been what I've noticed over the years. When
(17:09):
I see couples married, it's normally the female that's documenting everything,
that has the notepads and all of the paper and
the sticky notes and everything you know that they bring.
The guys are just kind of hanging out like, yeah, whatever, Hey, David,
what's going on?
Speaker 3 (17:28):
I think we got a bad connection.
Speaker 4 (17:30):
But if you can hear me, I had a question
about tonal fungus and how to get rid of it.
Speaker 1 (17:36):
Yeah, I can hear you. You're loud and clear. How
can we help you?
Speaker 3 (17:40):
I had a question about toenal fungus.
Speaker 1 (17:43):
Yes, sir, go ahead, you're live, David, you're live. Okay,
toenail fungus, that's a good one. We don't talk about
that that that much. I guess that's sort of not
a pleasant conversation. It's almost like with the colon cancer screening.
(18:06):
You know, we have our colonoscopies which have been around
for a long time, and some inconveniences with that you
have to take off, you have to drink all that solution,
and for a screening test or a screening tool, it's
it's not the best for the convenient part of it.
Speaker 3 (18:24):
Right.
Speaker 1 (18:25):
It's a thorough exam, but it's not the best in
terms of convenience, and most screening exams need to be convenient. David,
dear park, Yes, you're live. How can we help you?
Speaker 3 (18:38):
Uh, tonail fungus.
Speaker 4 (18:42):
Yes, I'm curious about the tonail fungus.
Speaker 1 (18:45):
Yeah, you're trying to get rid of it. Yes, yeah, David,
thank you for that question. That that's a very common
toenail problem or tonail infection, and primarily it's because Americans
like to wear closed toe shoes, leather shoes, tennis shoes, slippers,
(19:09):
whatever the case may be. The toe box, as they say,
most of the time, is closed, whereas if you go
to other countries, they're wearing shoes and sandals and flip
flops with an open toe area. Anyway, when you're constantly
putting your foot into sort of a closed environment like
(19:30):
a slipper or a shoe or work boots or whatever,
the inside the toe box area a lot of times
will develop debris and will get a little bit more
of a bacteria and infection environment because of frequent use,
and just it interacts with the foot because the foot
(19:50):
gets moist and the skin on the foot sheds, and
just a combination of things where that toebox can get
a little nasty. Ungus loves that environment, so normally after
a while you wear your favorite shoes every day, and
you may even take a bath and wear new socks
(20:11):
every day or fresh socks. It just gets a little
nasty in that toe box, and fungus likes to live
there in that environment, and eventually we'll get into that
toenail and cause an infection. And that's how most people
get it in this country. Not that they're nasty or
they're bad people, just we like to wear certain types
(20:31):
of footwear and leather footwear and it gets into that
toenail and causes that yellow, thick, irregular looking toe. And
sometimes it's normally it's that big toe that gets it first,
but you can all the toes can get that infection.
(20:51):
And most people just going with their lives, they don't
really even care about it. But every now and then
someone will say, hey, I don't like to wear my toenail.
Looks what's going on with that? And my experience, the
most effective way to get rid of that is, I mean,
number one, try and change your shoes and try to
let your foot breathe as much as possible. So maybe
get a few more pair of shoes, and when you
(21:13):
don't wear the shoes, you can put something inside the
shoe to sort of deodorize it and sanitize it. They
have a bunch of products over the counter where you
can do that. But in terms of treating the infection,
there's a medication called terbinifying. It's an anti fungal tablet
that you can take once a day. You normally have
(21:36):
to take it for three months. There was some concern
that it caused liver inflammation and liver failure. But I've
been using it for over twenty years and I've not
come across a patient that has suffered that problem. So
theoretically it's a potential an issue, but it tends to
not happen. But take that tablet once a day for
(21:57):
three months and it normally wipes it out very easily.
But you have to do your part moving forward to
not get reinfected. So, like I said, that might mean
getting several pair of shoes and wearing clean socks every day,
and as soon as you can get out of that shoe,
get your foot out of that shoe sometimes, Like I said,
(22:18):
sanitizing the inside of the shoe is a good idea,
and just try to keep your foot sort of in
an open environment as much as possible. That that really
cuts down in that Okay.
Speaker 4 (22:30):
All right, That sure does answer a lot of questions
because I spent many years.
Speaker 3 (22:35):
With you know, twelve and sixteen hour days. That's right work. Yeah.
Speaker 1 (22:40):
Our truck drivers are construction workers. They get it all
the time, big time.
Speaker 3 (22:45):
Yes, all right, then, well I appreciate it.
Speaker 1 (22:47):
Appreciate it, David. You have a good day, and again
most of us just sort of ignore it. It's not
a big deal. Your feet are like way down there,
and we're sort of way up here in terms of
what we're looking at every day, and sometimes we just
don't care about it, ignore it until something happens and
you look, like, what is going on down there? We
(23:09):
got some monster toenails down there and looks pretty nasty.
It's not anything life threatening, honestly. It's really a cosmetic
issue for the most part. Sometimes if the fungal infection spreads,
so a lot of times it'll start in that toenail there.
Like I said, that big toad, you know, the yellow, thick,
(23:31):
irregular looking toenail. That's basically how fungus toenails look. But
it can also infect your skin on the bottom as
well as the sides, and so you start sort of
having this very flaky skin. It looks just like dry skin.
To be honest with you, is what a fungal infection
looks like on the bottom of your foot. We have
(23:55):
described as sort of in a sort of a moccasin distribution,
and if you will, like if you're wearing a moccasin shoe,
it sort of looks like that sort of on the sides,
on the bottom and a little bit on the top,
like like I say, a moccasin, So it's very flaky.
You put lotion on it, like man, my feet is dry.
It's flaky and itches too, So you'll find yourself scratching
(24:20):
your foot all the time, especially in between the toes
where a lot of times again because of the shoes
you're wearing, and if you're sweating throughout their like sake,
my construction workers, truck drivers, people who work outside lawn service,
the chemical plants, you know, where you just sort of
(24:40):
wearing socks and it's hot, you have to wear gear,
and you have to wear protective shoes. And again, these
these boots that they wear, like these still toe boots,
and these boots that they wear in these certain environments
are expensive. They're not cheap, and just because of that,
(25:00):
you normally only have one pair and you want it
to last as long as possible. So you're wearing that
shoe frequently every day, and it just doesn't allow for
proper sanitation, so the inside of that shoe just gets
kind of nasty, and so you're putting your foot in
that every single day, even though it's a clean sock.
You're putting your foot in that every single day. It's
(25:22):
like a swamp in there, to be honest with you,
in terms of bacteria and fungus and debris and sand
and rocks, and just over time it builds up and
so that foot starts to look pretty bad, and so
you have to try and cycle your footwear and maybe
whar that bood once every four or five days because
(25:43):
you want the inside to sort of calm down. And
they have these you can look online Amazon where you
can put things inside that you have to wear it
to sort of deodorize it, sanitize it so that when
you put your foot back into it three or four
days later, it's a it's a clean area and you're
not exposing your foot and your toes to all of
that infection that's sitting in there. The favorite lawn shoes,
(26:07):
I'm going to cut the grass. I got my favorite
tennis shoes I wear that I always wear on my work.
Whatever it is. That's why most people get those toenail infections.
But certainly things like diabetes can increase your risk of
havinget's just because of the blood flow and the sugar
that normally will allow most skin infections to run rampant
(26:30):
without any protection, but the medications work very well. You've
seen some of the topical versions on commercials. Maybe you
went to the pharmacy and they have some topical toenail
liquids that you can put on there. There's some home remedies.
I think one of them it involves a little bleach solution,
(26:52):
warm water, some bleach, and I think it's some other
component I can't remember, but there's a lot of home
remedies for tone fungus out there, and you certainly can
try that, just because again, go into the doctor's office,
you got to make an employment, you got to wait,
and just all that big production. You just want something quick,
easy and convenient. I would probably if you have tonail
(27:15):
fungus now again on the side, very flaky dry, like
I said, you put lotion on there, but the lotion's
not killing it, right, it's a sort of a deeper,
more extensive dryness and flakiness and very itchy. That's normally fungus.
You could, Yeah, Lamba Seal has a great row of
products over the counter. They have some sprays and some
(27:38):
lotions and some creams. You can go get that, right
now from most of your local pharmacies and start using that,
and then again and pay and pay attention to your
shoes and try to sanitize your shoes to help with that.
But a lot of times if it's in that toe,
now you just got to get the tablets because it's
very potent systemic. It gets inside the toenail bed and
(28:02):
gets inside that circulation and kills that infection. But again,
to be convenient, just try the topical stuff to start
off with might be the way to go. Normally not
life threatening, right, you can live with this stuff. You
can live with it. It normally is not going to
cause you to have amputation or be hospitalized, nothing like that.
(28:23):
It just looks terrible to a lot of people. Phone
lines are open eight nine six kov. I want one
hundred three three zero kovy. I'll be back in two minutes.
All right, welcome back to DOCTAM. Medical Phone lines to
(28:44):
open eight none to six Kova. I want a hundred
three three zero ko. If y'all talking about just information
that's being shared with you now, it can be very
very confusing. Even though it's your information, you still need
some medical health professional to help you decipher what all
that red means, and just all the comments that are
(29:07):
made on the paperwork, it's still a lot of times
over patient's heads and they need someone who's on the inside, doctor, nurse, practitioner,
registered nurse to sort of help them understand what all
this stuff means, just because it can be conflicting. I mean,
because you're getting information from the pharmacists, you're getting information
(29:28):
from the minor care that you went to the night before,
You're getting information from your healthcare professional in terms of
your checkout sheet and the medicines you're on, and it's
all for good reason. If you're in the hospital and
you got discharge, you're getting sort of a discharge packet
that has some basic information in it. I know, working
(29:50):
with patients at m D Anderson and Methodists and using
they have what they call a my Chart platform where
a lot of times when patient come to the office,
they open up their phones and we look at their
information on their phone, what they're from their my chart
website where we can look at their most recent labs
(30:12):
and their X ray reports and sometimes comments from their
healthcare professionals. And I think that's just going to expand
more and more more and I'm all for that, because
because you need that information to help you make decisions.
We have Mark from East Texas. What's up.
Speaker 5 (30:30):
And good morning?
Speaker 1 (30:32):
Good morning? How can we help you your.
Speaker 5 (30:34):
Live Prevagon and nariva. I've heard the claims they make
in their ads. Do they work it best? Can they
help it worse? Can they do no harm? I'll hang
up and listen. I can hear the response better with
the radio.
Speaker 1 (30:53):
All right, Mark, we appreciate that. Prevagen p r e V,
prev pr eg and prevagen I think that's how you
spell it. And then the other one, Neuro's something I
can't remember, but Previgen seems to be the most popular
dietary supplement. Is what category it's in, To be honest
(31:15):
with you, it's not a prescription medication, but if you've
been looking at TV recently, I would say for the
past couple of years, it's been out. It's a dietary
supplement that's being advertised to the American public to help
with memory. And I think that most people understand that
as one gets older, I'm talking about just sort of
(31:38):
how your body re acts to disease and illness. But
the thing that we're mentioning is your systems will start
to shut down. Kidney stone work as well, heart doesn't
work as well, and the nervous system doesn't work as well,
including the brain, the central nervous system as we call it,
and one of its main functions among all the others
is memory formation and memory retention, memory function that's a
(32:03):
part of your brain, and that's one of the capacities
that slows down as you get older. And most people
will since that that they just don't have that power,
that capacity that they had to remember all these details.
And it is frightening and it is worrisome because most
(32:24):
elderly patients are aware of Alzheimer's dementia are dementia in general.
That's almost like saying you have cancer. When you bring
up dementia, that's a big term and that means a
lot when you tell someone that. And so as people
get older, they're trying to figure out how to prevent that,
(32:46):
how to reduce my chances of getting dementia. I don't
want that. I saw that in my friend or my family,
and I don't want that. What can I do? And
I would have to say, it's been disappointing, Like I said,
I've been a doctor over twenty years, and the approach,
the treatment, the diagnosis of dementia or Alzheimer's dementia, which
(33:09):
is the most common form of dementia. Remember that's various
types of dementia, but Alzheimer's is the most common in
our country. The approach, the diagnostic capability, the medicines that
we have for Alzheimer's dementia. Not a lot has changed
in over twenty years. There was a drug that did
(33:33):
come out of maybe a year ago or so that's
an IV medication for patients who have dementia. But that
drug in and of itself is extremely controversial. It's not
very effective, it's only exclusive to neurologists and certain patients.
You have to have all sorts of testing before taking it,
(33:55):
testing after taking It's almost like the medicine kind of
got to the market kind of quickly, and they still
need to have heavy surveillance with the product in order
to use it on the open market. So that's why
you have to have testing before, testing after testing during
this particular medication because it's not easy to use as
(34:19):
probably adverse reaction issues. And again I don't have any
exposure to it in terms of using them because it's
mainly just for neurologists to use it. And again it's
not a what we would call a general population medication
where you can easily go to your healthcare provider, get
the medication, start taking it. It works, everybody's happy, right,
(34:43):
And that product came out about a year two. I
don't even know the name of it, because again I
haven't prescribed it, but I remember when it came out
was very controversial with experts. A lot of experts feel
like it wasn't effective and had too many side effects.
Said hey, we don't have anything else, let some we've
got to go with it. Right, Remember when AIDS and
(35:04):
HIV hit the scene, when people were dying and we
were sort of behind on what to do about it,
and so certain products got rushed to the market to
just give them something to help, even though it's very
toxic and it wasn't really meant for HIV. And sort
of the same thing with this particular product, right, not
(35:25):
probably the best, but it's something patients are struggling out
there to preserve their brain function. So Prevagen and this
other dietary supplet new neurogen or I can't remember the
name of it, and I apologize about that. These are
just dietary supplements, and the question is does it work?
And should I use it? And kennon cause any harm?
(35:50):
And I think the biggest questions does it work? That's
in order to answer that question, they would have to
study that product in a certain way, and normally, when
you study it in a proper format, it's normally very lengthy,
very expensive. And the laws of the land here in
this country don't make these sort of companies when it's
(36:14):
in a dietary supplement fashion. They don't make these companies
study their product in that way. They don't have to
in order to bring it to the market advertising. They
just don't have to do it. And that's a risk
for a company to do that, right. It's like, Okay,
we want to be good, we want to know for sure,
so we're going to study it. Right, and you create
(36:34):
a study, it takes five to ten years, all sorts
of money gets invested, and then at the end of
the day you realize the product doesn't work. I mean,
that's not a good position of being. So it's risky.
And if you don't have to do it, why do
you do it. You're allowed because it's a dietary supplement,
you're allowed a lot of leverage, a lot of freedom
(36:55):
to say all sorts of things in your advertisement. That's
just the way America works, where you can sort of
say things like maybe it works and maybe it helps
and whatever. They say. I haven't seen a commercial recently,
but doctors really don't know if it works because it
has not been studied properly in a peer reviewed fashion.
(37:16):
Is what it takes for a doctor to bring that
to a patient say hey, you really need to take this.
This stuff works because normally, when we say that the
product has been studied in a certain fashion so that
we have hard facts, hard results, it does work. We've
done it in a fashion to prove it to ourselves.
(37:37):
That takes a lot of time, alot of money, and
most of these companies are not going to do it
because they don't have to. So most of your doctors,
healthcare providers, and inspectors, they're not really going to know
if it works for you. It's a dietary subtlement. It's
like a vitamin, right. I mean a lot of patients
going to be hey, does this vitamin work? Can I
take it? Sure? Go ahead and try it, because we
just don't know, but I know that people are trying
(38:00):
to do what they can in a simple, easy, straightforward
fashion to preserve their memory. And if there's something I
can take a liquid or spray, a capsule, a tablet,
I just need to take it. Boom, I'm done, easy clean.
You know that makes sense, right, So I don't really
get in the way of someone who wants to take
(38:22):
previaging and these these other dietary supplements. As the caller mentioned,
it normally is not hormful, so why not try it?
I mean, I have no problem with that, but honestly,
I don't think anyone knows if it works. I don't
have that many people on prevagen. I think most people
they take it for five or six months, nothing happens,
(38:45):
so they stop taking it. That that's been my biggest experience.
It's not taken very long, let me put it that way,
just because they most people just don't get anything out
of it. They'll try it for six months, see how works.
And I think it's a little expensive. It's not cheap,
and so it kind of starts to eat into your
pocket and it's not working, so you stop it. So
(39:08):
if someone asked me, I would say hey, try it.
If you want to give it, give it six months,
see how it works, and if it helps, then keep taking.
If not, then probably go ahead and discontinue. And I
have not seen any toxicity issues with it, so probably
very safe to take. Phone lines are open eight nine
six kov I won one hundred three three zero O Kova.
I'll be back in two minutes. All right, welcome back
(39:38):
to the doctor. Livi and Medagat. Phone lines are open
eight nine six k I want one hundred and three
three zero O ko v I. At the end of
the show, I want to think all their callers and
the listeners and if there's a certain topic you'd like
me to talk about, please let us know. We can
jump into that. But our last caller with the dietary
supplement prevagen, which is very popular. A lot of patients
(40:01):
are taking it individual results. I would say, if you
want to try and reduce your chances of getting dementia,
it's not about one little thing that you do, which
is the same thing with your general health. A lot
of people will go to the store and sort of
(40:22):
get all of these dietary supplements, vitamins, MegaMan pack things
of that nature, start taking that and feel like they're
really doing something to help with their health. And you know,
if you want to do that, that's fine, but it
really gives your false sense of security. It just doesn't
work that way, right, even when it comes to dementia.
(40:44):
I mean, you can't have high blood pressure, hot sugar
and not exercise, and eat a bad diet and smoke
and then take prevaging. That's going to overcome all of
these other things that you're doing to the human body
that certainly can increase your risk of dementia. You got
(41:05):
to do the basics first. You can't get away from that.
You got to treat your body right. That's really the
most important aspect of your health is your lifestyle. What
are you eating, what are you drinking, and what's your
activity like. If that is not right, prevagen is not
going to work or nothing's going to work right, But
(41:27):
it doesn't mean you're going to get dementia. Just that
we've found over the years patients who are in poor
health tend to develop that more than those who are
in good health. So that's why you can never get
away from eating your vegetables, limiting your sugars and starches,
and yes, being physically active. That stuff is gold or platinum,
(41:50):
whoever you talk to. That's really how you reduce your
chances of getting dementia. You got to eat the right food,
stay away from the wrong foods and beverages, and be
physically active. Stay involved, whether it be volunteering, talking to friends, family,
learning new skills. Don't sit around at home doing nothing,
(42:11):
not using your brain. That's not good. That can increase
risk of that as well. It's not all about that
one supplement you're taking. It's that lifestyle that feeds into that.
That's the one thing that I like to remind patients
that you can't just go down to the store buy
this man made product, start drinking it, taking it, eating it.
(42:35):
But you're not exercising, You're overweight, your sugars maybe not control,
your blood pressure is still high, you're not sleeping. It
doesn't work that way. I'm sorry. Got to put the
work in in order to get it out as you
get older. Have a good weekend, no drinking and driving.
We'll see you guys next week.
All right, Southeast sexist Internet radio listeners, Welcome to another
edition of the Doctor Levine Medical Hour. I am Doctor Levine,
your routine weekly host. I'm live at the studios of
KLVI here in Beaumont, Texas, cross the street from Parkdale Mall,
(00:20):
taking your phone calls, answering questions about healthcare and health
questions to try and help you stay alive, healthy as
long as possible, because that can be difficult. Phone lines
are open eight nine six klv I won eight hundred
three three zero kov I. We'd love to hear from
you and answer your question and see if we can
(00:44):
get you some information, make you feel better, help you
figure out what's good for you, what's good for your family,
as there's so much information and misinformation out there for
a good reason. I mean, I remember when I first
started this journey becoming a medical professional. We didn't really
(01:04):
share other than you're a practitioner, telling you and talking
with you. We didn't really share a lot of information,
your own information with you so that you can digest
that better. It was sort of what we call point
of care sharing of information, where you're in front of
(01:24):
your healthcare provider and you're sort of talking about your situation,
and you're supposed to remember everything that they say, you know,
when you're sick and you're on pain meds and you're
throwing up, and you're just supposed to remember everything. And
you know, when you're sick, you don't really want to
receive information and you just want to feel better. Y'all
(01:47):
sort of focused on the pain. It's difficult to remember
all these things that your doctor a healthcare professional taught
you or is telling you what to do to feel better.
And the system has gotten a lot better at sharing
that information with you, especially with the use of what
they call electronic medical records as well as these sort
(02:12):
of patient portals where you get a password or a
code word and you can access some of your information
that is available. A lot of times it's lab work
and upcoming appointments or past appointments, or even messaging between
you and your healthcare provider. The healthcare provider sending you messages,
(02:35):
or you sending your healthcare provider, or even the office
of your healthcare provider sending them messages, getting your appointments,
maybe getting some updates, just a better way to communicate
and share that information. So the whole system in general
has gotten to that point where a lot of the
(02:57):
information medical information is available to you. When I came
out and became a physician, that information was somewhat exclusive
to healthcare providers. You know, we had drinking my morning
coffee decaf can't tolerate the caffeine anymore, can sometimes cause palpitations,
(03:21):
and I'm drink coffee throughout the day, typically had to
go decaf on you guys. It still still has a
little caffeine in it, but certainly not as much as
the real thing. But back to when I first came out,
a lot of that information was exclusive to the practitioner,
meaning the average person just didn't have access to a
(03:45):
lot of medical info and medical knowledge, and so everything
sort of came from the physician. And now we have
what we call physician extenders and those practitioners physician assistants.
Their presence has grown each year. I don't see that
slowing down. They provide a necessary service in the healthcare community,
(04:08):
a lot of different avenues that they found themselves in
just helping out and doing some good work. But the
information was just more exclusive and limited, and patients were
really in the dark about a lot of what was
going on and what was happening is mysterious. But now
(04:30):
that the floodgates of information have opened and they're now
accessible to a lot of times, information gets to the
patient faster than it gets to a practitioner, and we're
sort of sometimes behind. Patients come in with their news
or events or twenty four updates with what's going on
(04:52):
and bring it to us to sort of talk about it,
and a lot of times we've never heard about it.
I mean, because there's so much information, every practitioner sort
of has their source of information that they go to. Personally,
I listen to the satellite radio. They have a doctor's
channel on the satellite radio Serious XM. I've had the
(05:16):
satellite radio for many years, let's say fifteen years I've
had that. I love it, and they have a doctor
channel on there, and that's primarily what I listen to.
When I'm in the car or I'm going out of town,
I listen to that station, and that's where I get
a lot of my information just listening to other doctors
talk about a lot of these topics and what's going
(05:39):
on in their lives and what's new in healthcare. So
everybody has their source Leonard from Houston, what's up?
Speaker 2 (05:48):
About six weeks ago? But I burned the bottle on
my feet and they blister and it popped, and they've
been leaking ever since. The bleeding is stop, but I'm
still getting that pushed stuff out of them. Change the
bandage just two or three times a day, neo spoor
and that kind of stuff. Is there anything else I
should be doing to help speed that recovery?
Speaker 1 (06:11):
I mean no, I don't think so. Most of the time,
these superficial wounds, which it sounds like your injury was
a sort of a stage one or a Grade one
injury to the skin, which again it can cause the
top layer to what we call slough off or die,
and it exposes the more deeper layers of the skin layer.
(06:35):
Because the skin does have several layers, even though it's
super thin, it has different layers and each layer has
different responsibilities. Most of the time with those sort of
stage one are Grade one lesions, you just have to
keep it clean and do some wound therapy. You're correct,
(06:56):
I mean sort of keep the area clean. If there's
any dead skin in any drainage, sort of dry that
up and remove that. There's a lot of products over
the counter that patients have access to where they can
sort of do their own wound therapy. There's podcasts and
sort of websites you can go to for basic wound therapy.
I was talking about that this morning. And normally, under
(07:19):
normal circumstances, it gets better over time. But Leonard, I
know you have diabetes, and we care a lot about
foot care for diabetic patients, and certainly if you're wound
is not improving, then probably you need to go to
a professional, probably a peddiet since it's dealing with your foot.
Speaker 2 (07:41):
I've better see the foot doctor and he's you know,
I'm doing what he says. It just seems like it's
taken a long time. It is getting better, and I
can tell that, but it just seems like it's taken
a long time.
Speaker 1 (07:55):
Well, Leonard, yeah, absolutely, and it's one of the aspects
unfortunately of getting older. You've called over the years. I
know you're up in age and you do have diabetes,
and the numbers you give me says you're under control.
But the body just doesn't heal as rapidly when you're older.
It just doesn't. And it's a rude awakening. I'm sorry.
(08:18):
And I try to explain that as much as I
can on this show. Is your body just slows down.
It doesn't do very well with acute injury. And so yeah,
that wound might take a month two months to heal,
whereas if you were in your twenties it would heal
within a couple of weeks. That's just how the body works.
But like you said, it sounds like it's going in
(08:39):
the right direction.
Speaker 2 (08:41):
Good now, thanks Greg.
Speaker 1 (08:42):
Guys all right, Leonard, I appreciate that. Have a good weekend.
It's out of the heat. I have this something that
I mean, I've just noticed as a doctor helping elderly
patients and being in the hospital every day being an
ICU over the years twenty years, my well wife and
(09:08):
I realized that we've been in practice for almost nineteen years.
We're like, wow, it went by fast, super fast. Anyway,
as we get older, that aging process, I know, we
hate it, right that as we get older, were supposed
to have be live in the golden years, right, retire
and have fun and the sunset and just everything is gravy.
(09:34):
But man, it's not. For a lot of people. Just
as you get older, things to actually start breaking down
and you really, really, really have to understand that issue.
And if you don't want to break down, you want
to be healthy, you don't want to be in the
doctor's office. You really have to put some effort into
not abusing your body and taking care of your body.
(09:56):
You really got to do it. And if you don't,
then yeah, you more than likely going to spend a
lot of your time at the doctor's office. You know, ill,
chronically ill, taking prescription medications, going to a bunch of
doctor visits. Just your whole life is sort of consumed
(10:16):
by being ill, and chronically ill that is. And I
can tell you it's really not fun. It limits your
ability to travel, It limits your dietary issues. You just
can't eat this, can't drink that, and you feel bad
all the time. It's really no fun. And the one
(10:37):
thing is, like i've Leonard has we were talking about,
is the body just doesn't heal as well. And that
goes for as I've mentioned on this show, acute to
medical trauma, which is sort of what I call a
lot of the things that happen to elderly patients as
they get older, a stroke, a heart attack, and acute infection,
(10:59):
which we've called sepsis, it could be a bladder infection,
and skin infection, lung infection, we see that, but there's
a whole host of other infections that happens when you
get older. They just happen. And again a couple of
reasons why that is is the immune system just doesn't
(11:20):
work as well. We were talking about the skin system
and how it heals, but the immune system slows down too,
which we promote vaccines all the time, and I know
you guys get sick of me saying that and recommending it,
but you have to understand what's happening in the background
as you get up into your fifties, sixties, seventies, eighties.
(11:42):
I mean, it just keeps going. It's programmed into all
of us, to our system to sort of start auto
shut down mode, if you will, where all the systems
will just sort of start to shut down. They don't
work as well and are vulnerable to any sort of
(12:03):
acute illness or crises that occurs to us. And when
it happens, sometimes it's too much for the body to tolerate,
which you know, if you're elderly and you have friends
and family, you know so and so that live down
the street, are a girlfriend that you talk to or
a family member that is up in age. They get
(12:23):
in the hospital and things don't go well and they
might not ever leave the hospital, which, again, as a
medical doctor, I understand that completely because again I've done
it for so many years, I've seen it happen in
front of my eyes. Is again, you get a sepsis
episode from your inn atract infection or let's just say pneumonia,
(12:47):
and the pneumonia is sort of overwhelming. You have some
heart problems, some kidney problems that you've been taking your medicines.
You've been going to your kidney doctor and your heart doctor,
and everything is fine as long as you don't you're
not sick. Right, there's sometimes a false sense of security
(13:07):
when you go to your doctor and he's like app
everything or she is, you're doing good, We're not going
to change anything, and we walk out feeling great, and
I think that's all wonderful that you're doing your part.
But you could come down with a cute lung infection
blad infection, and you're in the hospital two weeks later,
you know, fighting for your life. And that's because as
(13:31):
long as as long as there's no acute illness and
you're sort of what we call steady state. There's no crises,
there's no trauma. Everything's good. Your body can tolerate that.
You can take your edge and go to sleep, eat,
everything's great. But once you get some trauma in there,
some stress on the human body, and you're stressing that
(13:52):
heart out and those kidneys and that liver and that brain,
the nervous system. How many times maybe you've been to
the hospital to visit your mother or your wife, your husband,
and he's confused, he doesn't know who you are. He's
pulling out his ivs, he won't go to sleep, he's
running down the hall with no clothes on. I mean,
(14:14):
this stuff happens right every day in the hospital. I
mean it's amazing to me, even in the emergency department.
If you've ever been in a modern emergency department, you
see all the things that are happening in front of you,
and it happens every day. And it's sort of shocking
to me that this stuff is happening every day, but
(14:34):
it is. And you really really understand that. Again, as
we get older, just the body is not built for stress.
As we get a to go get those vaccines, right, flu, pneumonia, shingles,
covid are as. We go get him today if you
(14:55):
haven't had him, phone line to open eight nine to
six klv I when in one hundred three threes zero kovy.
I'll be back in two minutes. Oh right, Welcome back
(15:15):
to the Doctoravie. Medical phone lines are open eight nine
six kov I one hundred and three to three zero
ko v I talking about various topics this morning, getting
those vaccines and staying out of the hospital, as well
as all the information that patients are getting now, I
mean it's god, I mean an enormous amount. I mean,
(15:38):
every step of the way, you're getting all this paperwork
put in front of you about all sorts of things.
And I think it's a good thing, to be honest
with you, it really is. I mean I sort of
chuckle at when I first came out, we just sort
of talked to patients and maybe the most paperwork they
would get is a receipt and then maybe some paper
(16:01):
prescriptions for the medications that they were supposed to get, right,
and sometimes you walk out a bunch of prescriptions. But now,
because of various modern conveniences and advancements with electronic medical records.
A lot of that information is more easily shared, and
the understanding is that it allows the patient to understand
(16:25):
better what is going wrong with them, and what the
thoughts of the doctors and the healthcare providers, and just
documenting more clearly the diagnoses, where they went, medications are taking.
I mean, all of that stuff, in my opinion, is
useful information, very useful information for everyone. That would be
(16:49):
all the providers as well as the patients themselves. Some
patients are better at documenting everything that happens with them.
You see the wifer, it's it's mainly mainly the wife, right. Guys,
for whatever reason, don't get into a lot of that.
That's just been what I've noticed over the years. When
(17:09):
I see couples married, it's normally the female that's documenting everything,
that has the notepads and all of the paper and
the sticky notes and everything you know that they bring.
The guys are just kind of hanging out like, yeah, whatever, Hey, David,
what's going on?
Speaker 3 (17:28):
I think we got a bad connection.
Speaker 4 (17:30):
But if you can hear me, I had a question
about tonal fungus and how to get rid of it.
Speaker 1 (17:36):
Yeah, I can hear you. You're loud and clear. How
can we help you?
Speaker 3 (17:40):
I had a question about toenal fungus.
Speaker 1 (17:43):
Yes, sir, go ahead, you're live, David, you're live. Okay,
toenail fungus, that's a good one. We don't talk about
that that that much. I guess that's sort of not
a pleasant conversation. It's almost like with the colon cancer screening.
(18:06):
You know, we have our colonoscopies which have been around
for a long time, and some inconveniences with that you
have to take off, you have to drink all that solution,
and for a screening test or a screening tool, it's
it's not the best for the convenient part of it.
Speaker 3 (18:24):
Right.
Speaker 1 (18:25):
It's a thorough exam, but it's not the best in
terms of convenience, and most screening exams need to be convenient. David,
dear park, Yes, you're live. How can we help you?
Speaker 3 (18:38):
Uh, tonail fungus.
Speaker 4 (18:42):
Yes, I'm curious about the tonail fungus.
Speaker 1 (18:45):
Yeah, you're trying to get rid of it. Yes, yeah, David,
thank you for that question. That that's a very common
toenail problem or tonail infection, and primarily it's because Americans
like to wear closed toe shoes, leather shoes, tennis shoes, slippers,
(19:09):
whatever the case may be. The toe box, as they say,
most of the time, is closed, whereas if you go
to other countries, they're wearing shoes and sandals and flip
flops with an open toe area. Anyway, when you're constantly
putting your foot into sort of a closed environment like
(19:30):
a slipper or a shoe or work boots or whatever,
the inside the toe box area a lot of times
will develop debris and will get a little bit more
of a bacteria and infection environment because of frequent use,
and just it interacts with the foot because the foot
(19:50):
gets moist and the skin on the foot sheds, and
just a combination of things where that toebox can get
a little nasty. Ungus loves that environment, so normally after
a while you wear your favorite shoes every day, and
you may even take a bath and wear new socks
(20:11):
every day or fresh socks. It just gets a little
nasty in that toe box, and fungus likes to live
there in that environment, and eventually we'll get into that
toenail and cause an infection. And that's how most people
get it in this country. Not that they're nasty or
they're bad people, just we like to wear certain types
(20:31):
of footwear and leather footwear and it gets into that
toenail and causes that yellow, thick, irregular looking toe. And
sometimes it's normally it's that big toe that gets it first,
but you can all the toes can get that infection.
(20:51):
And most people just going with their lives, they don't
really even care about it. But every now and then
someone will say, hey, I don't like to wear my toenail.
Looks what's going on with that? And my experience, the
most effective way to get rid of that is, I mean,
number one, try and change your shoes and try to
let your foot breathe as much as possible. So maybe
get a few more pair of shoes, and when you
(21:13):
don't wear the shoes, you can put something inside the
shoe to sort of deodorize it and sanitize it. They
have a bunch of products over the counter where you
can do that. But in terms of treating the infection,
there's a medication called terbinifying. It's an anti fungal tablet
that you can take once a day. You normally have
(21:36):
to take it for three months. There was some concern
that it caused liver inflammation and liver failure. But I've
been using it for over twenty years and I've not
come across a patient that has suffered that problem. So
theoretically it's a potential an issue, but it tends to
not happen. But take that tablet once a day for
(21:57):
three months and it normally wipes it out very easily.
But you have to do your part moving forward to
not get reinfected. So, like I said, that might mean
getting several pair of shoes and wearing clean socks every day,
and as soon as you can get out of that shoe,
get your foot out of that shoe sometimes, Like I said,
(22:18):
sanitizing the inside of the shoe is a good idea,
and just try to keep your foot sort of in
an open environment as much as possible. That that really
cuts down in that Okay.
Speaker 4 (22:30):
All right, That sure does answer a lot of questions
because I spent many years.
Speaker 3 (22:35):
With you know, twelve and sixteen hour days. That's right work. Yeah.
Speaker 1 (22:40):
Our truck drivers are construction workers. They get it all
the time, big time.
Speaker 3 (22:45):
Yes, all right, then, well I appreciate it.
Speaker 1 (22:47):
Appreciate it, David. You have a good day, and again
most of us just sort of ignore it. It's not
a big deal. Your feet are like way down there,
and we're sort of way up here in terms of
what we're looking at every day, and sometimes we just
don't care about it, ignore it until something happens and
you look, like, what is going on down there? We
(23:09):
got some monster toenails down there and looks pretty nasty.
It's not anything life threatening, honestly. It's really a cosmetic
issue for the most part. Sometimes if the fungal infection spreads,
so a lot of times it'll start in that toenail there.
Like I said, that big toad, you know, the yellow, thick,
(23:31):
irregular looking toenail. That's basically how fungus toenails look. But
it can also infect your skin on the bottom as
well as the sides, and so you start sort of
having this very flaky skin. It looks just like dry skin.
To be honest with you, is what a fungal infection
looks like on the bottom of your foot. We have
(23:55):
described as sort of in a sort of a moccasin distribution,
and if you will, like if you're wearing a moccasin shoe,
it sort of looks like that sort of on the sides,
on the bottom and a little bit on the top,
like like I say, a moccasin, So it's very flaky.
You put lotion on it, like man, my feet is dry.
It's flaky and itches too, So you'll find yourself scratching
(24:20):
your foot all the time, especially in between the toes
where a lot of times again because of the shoes
you're wearing, and if you're sweating throughout their like sake,
my construction workers, truck drivers, people who work outside lawn service,
the chemical plants, you know, where you just sort of
(24:40):
wearing socks and it's hot, you have to wear gear,
and you have to wear protective shoes. And again, these
these boots that they wear, like these still toe boots,
and these boots that they wear in these certain environments
are expensive. They're not cheap, and just because of that,
(25:00):
you normally only have one pair and you want it
to last as long as possible. So you're wearing that
shoe frequently every day, and it just doesn't allow for
proper sanitation, so the inside of that shoe just gets
kind of nasty, and so you're putting your foot in
that every single day, even though it's a clean sock.
You're putting your foot in that every single day. It's
(25:22):
like a swamp in there, to be honest with you,
in terms of bacteria and fungus and debris and sand
and rocks, and just over time it builds up and
so that foot starts to look pretty bad, and so
you have to try and cycle your footwear and maybe
whar that bood once every four or five days because
(25:43):
you want the inside to sort of calm down. And
they have these you can look online Amazon where you
can put things inside that you have to wear it
to sort of deodorize it, sanitize it so that when
you put your foot back into it three or four
days later, it's a it's a clean area and you're
not exposing your foot and your toes to all of
that infection that's sitting in there. The favorite lawn shoes,
(26:07):
I'm going to cut the grass. I got my favorite
tennis shoes I wear that I always wear on my work.
Whatever it is. That's why most people get those toenail infections.
But certainly things like diabetes can increase your risk of
havinget's just because of the blood flow and the sugar
that normally will allow most skin infections to run rampant
(26:30):
without any protection, but the medications work very well. You've
seen some of the topical versions on commercials. Maybe you
went to the pharmacy and they have some topical toenail
liquids that you can put on there. There's some home remedies.
I think one of them it involves a little bleach solution,
(26:52):
warm water, some bleach, and I think it's some other
component I can't remember, but there's a lot of home
remedies for tone fungus out there, and you certainly can
try that, just because again, go into the doctor's office,
you got to make an employment, you got to wait,
and just all that big production. You just want something quick,
easy and convenient. I would probably if you have tonail
(27:15):
fungus now again on the side, very flaky dry, like
I said, you put lotion on there, but the lotion's
not killing it, right, it's a sort of a deeper,
more extensive dryness and flakiness and very itchy. That's normally fungus.
You could, Yeah, Lamba Seal has a great row of
products over the counter. They have some sprays and some
(27:38):
lotions and some creams. You can go get that, right
now from most of your local pharmacies and start using that,
and then again and pay and pay attention to your
shoes and try to sanitize your shoes to help with that.
But a lot of times if it's in that toe,
now you just got to get the tablets because it's
very potent systemic. It gets inside the toenail bed and
(28:02):
gets inside that circulation and kills that infection. But again,
to be convenient, just try the topical stuff to start
off with might be the way to go. Normally not
life threatening, right, you can live with this stuff. You
can live with it. It normally is not going to
cause you to have amputation or be hospitalized, nothing like that.
(28:23):
It just looks terrible to a lot of people. Phone
lines are open eight nine six kov. I want one
hundred three three zero kovy. I'll be back in two minutes.
All right, welcome back to DOCTAM. Medical Phone lines to
(28:44):
open eight none to six Kova. I want a hundred
three three zero ko. If y'all talking about just information
that's being shared with you now, it can be very
very confusing. Even though it's your information, you still need
some medical health professional to help you decipher what all
that red means, and just all the comments that are
(29:07):
made on the paperwork, it's still a lot of times
over patient's heads and they need someone who's on the inside, doctor, nurse, practitioner,
registered nurse to sort of help them understand what all
this stuff means, just because it can be conflicting. I mean,
because you're getting information from the pharmacists, you're getting information
(29:28):
from the minor care that you went to the night before,
You're getting information from your healthcare professional in terms of
your checkout sheet and the medicines you're on, and it's
all for good reason. If you're in the hospital and
you got discharge, you're getting sort of a discharge packet
that has some basic information in it. I know, working
(29:50):
with patients at m D Anderson and Methodists and using
they have what they call a my Chart platform where
a lot of times when patient come to the office,
they open up their phones and we look at their
information on their phone, what they're from their my chart
website where we can look at their most recent labs
(30:12):
and their X ray reports and sometimes comments from their
healthcare professionals. And I think that's just going to expand
more and more more and I'm all for that, because
because you need that information to help you make decisions.
We have Mark from East Texas. What's up.
Speaker 5 (30:30):
And good morning?
Speaker 1 (30:32):
Good morning? How can we help you your.
Speaker 5 (30:34):
Live Prevagon and nariva. I've heard the claims they make
in their ads. Do they work it best? Can they
help it worse? Can they do no harm? I'll hang
up and listen. I can hear the response better with
the radio.
Speaker 1 (30:53):
All right, Mark, we appreciate that. Prevagen p r e V,
prev pr eg and prevagen I think that's how you
spell it. And then the other one, Neuro's something I
can't remember, but Previgen seems to be the most popular
dietary supplement. Is what category it's in, To be honest
(31:15):
with you, it's not a prescription medication, but if you've
been looking at TV recently, I would say for the
past couple of years, it's been out. It's a dietary
supplement that's being advertised to the American public to help
with memory. And I think that most people understand that
as one gets older, I'm talking about just sort of
(31:38):
how your body re acts to disease and illness. But
the thing that we're mentioning is your systems will start
to shut down. Kidney stone work as well, heart doesn't
work as well, and the nervous system doesn't work as well,
including the brain, the central nervous system as we call it,
and one of its main functions among all the others
is memory formation and memory retention, memory function that's a
(32:03):
part of your brain, and that's one of the capacities
that slows down as you get older. And most people
will since that that they just don't have that power,
that capacity that they had to remember all these details.
And it is frightening and it is worrisome because most
(32:24):
elderly patients are aware of Alzheimer's dementia are dementia in general.
That's almost like saying you have cancer. When you bring
up dementia, that's a big term and that means a
lot when you tell someone that. And so as people
get older, they're trying to figure out how to prevent that,
(32:46):
how to reduce my chances of getting dementia. I don't
want that. I saw that in my friend or my family,
and I don't want that. What can I do? And
I would have to say, it's been disappointing, Like I said,
I've been a doctor over twenty years, and the approach,
the treatment, the diagnosis of dementia or Alzheimer's dementia, which
(33:09):
is the most common form of dementia. Remember that's various
types of dementia, but Alzheimer's is the most common in
our country. The approach, the diagnostic capability, the medicines that
we have for Alzheimer's dementia. Not a lot has changed
in over twenty years. There was a drug that did
(33:33):
come out of maybe a year ago or so that's
an IV medication for patients who have dementia. But that
drug in and of itself is extremely controversial. It's not
very effective, it's only exclusive to neurologists and certain patients.
You have to have all sorts of testing before taking it,
(33:55):
testing after taking It's almost like the medicine kind of
got to the market kind of quickly, and they still
need to have heavy surveillance with the product in order
to use it on the open market. So that's why
you have to have testing before, testing after testing during
this particular medication because it's not easy to use as
(34:19):
probably adverse reaction issues. And again I don't have any
exposure to it in terms of using them because it's
mainly just for neurologists to use it. And again it's
not a what we would call a general population medication
where you can easily go to your healthcare provider, get
the medication, start taking it. It works, everybody's happy, right,
(34:43):
And that product came out about a year two. I
don't even know the name of it, because again I
haven't prescribed it, but I remember when it came out
was very controversial with experts. A lot of experts feel
like it wasn't effective and had too many side effects.
Said hey, we don't have anything else, let some we've
got to go with it. Right, Remember when AIDS and
(35:04):
HIV hit the scene, when people were dying and we
were sort of behind on what to do about it,
and so certain products got rushed to the market to
just give them something to help, even though it's very
toxic and it wasn't really meant for HIV. And sort
of the same thing with this particular product, right, not
(35:25):
probably the best, but it's something patients are struggling out
there to preserve their brain function. So Prevagen and this
other dietary supplet new neurogen or I can't remember the
name of it, and I apologize about that. These are
just dietary supplements, and the question is does it work?
And should I use it? And kennon cause any harm?
(35:50):
And I think the biggest questions does it work? That's
in order to answer that question, they would have to
study that product in a certain way, and normally, when
you study it in a proper format, it's normally very lengthy,
very expensive. And the laws of the land here in
this country don't make these sort of companies when it's
(36:14):
in a dietary supplement fashion. They don't make these companies
study their product in that way. They don't have to
in order to bring it to the market advertising. They
just don't have to do it. And that's a risk
for a company to do that, right. It's like, Okay,
we want to be good, we want to know for sure,
so we're going to study it. Right, and you create
(36:34):
a study, it takes five to ten years, all sorts
of money gets invested, and then at the end of
the day you realize the product doesn't work. I mean,
that's not a good position of being. So it's risky.
And if you don't have to do it, why do
you do it. You're allowed because it's a dietary supplement,
you're allowed a lot of leverage, a lot of freedom
(36:55):
to say all sorts of things in your advertisement. That's
just the way America works, where you can sort of
say things like maybe it works and maybe it helps
and whatever. They say. I haven't seen a commercial recently,
but doctors really don't know if it works because it
has not been studied properly in a peer reviewed fashion.
(37:16):
Is what it takes for a doctor to bring that
to a patient say hey, you really need to take this.
This stuff works because normally, when we say that the
product has been studied in a certain fashion so that
we have hard facts, hard results, it does work. We've
done it in a fashion to prove it to ourselves.
(37:37):
That takes a lot of time, alot of money, and
most of these companies are not going to do it
because they don't have to. So most of your doctors,
healthcare providers, and inspectors, they're not really going to know
if it works for you. It's a dietary subtlement. It's
like a vitamin, right. I mean a lot of patients
going to be hey, does this vitamin work? Can I
take it? Sure? Go ahead and try it, because we
just don't know, but I know that people are trying
(38:00):
to do what they can in a simple, easy, straightforward
fashion to preserve their memory. And if there's something I
can take a liquid or spray, a capsule, a tablet,
I just need to take it. Boom, I'm done, easy clean.
You know that makes sense, right, So I don't really
get in the way of someone who wants to take
(38:22):
previaging and these these other dietary supplements. As the caller mentioned,
it normally is not hormful, so why not try it?
I mean, I have no problem with that, but honestly,
I don't think anyone knows if it works. I don't
have that many people on prevagen. I think most people
they take it for five or six months, nothing happens,
(38:45):
so they stop taking it. That that's been my biggest experience.
It's not taken very long, let me put it that way,
just because they most people just don't get anything out
of it. They'll try it for six months, see how works.
And I think it's a little expensive. It's not cheap,
and so it kind of starts to eat into your
pocket and it's not working, so you stop it. So
(39:08):
if someone asked me, I would say hey, try it.
If you want to give it, give it six months,
see how it works, and if it helps, then keep taking.
If not, then probably go ahead and discontinue. And I
have not seen any toxicity issues with it, so probably
very safe to take. Phone lines are open eight nine
six kov I won one hundred three three zero O Kova.
I'll be back in two minutes. All right, welcome back
(39:38):
to the doctor. Livi and Medagat. Phone lines are open
eight nine six k I want one hundred and three
three zero O ko v I. At the end of
the show, I want to think all their callers and
the listeners and if there's a certain topic you'd like
me to talk about, please let us know. We can
jump into that. But our last caller with the dietary
supplement prevagen, which is very popular. A lot of patients
(40:01):
are taking it individual results. I would say, if you
want to try and reduce your chances of getting dementia,
it's not about one little thing that you do, which
is the same thing with your general health. A lot
of people will go to the store and sort of
(40:22):
get all of these dietary supplements, vitamins, MegaMan pack things
of that nature, start taking that and feel like they're
really doing something to help with their health. And you know,
if you want to do that, that's fine, but it
really gives your false sense of security. It just doesn't
work that way, right, even when it comes to dementia.
(40:44):
I mean, you can't have high blood pressure, hot sugar
and not exercise, and eat a bad diet and smoke
and then take prevaging. That's going to overcome all of
these other things that you're doing to the human body
that certainly can increase your risk of dementia. You got
(41:05):
to do the basics first. You can't get away from that.
You got to treat your body right. That's really the
most important aspect of your health is your lifestyle. What
are you eating, what are you drinking, and what's your
activity like. If that is not right, prevagen is not
going to work or nothing's going to work right, But
(41:27):
it doesn't mean you're going to get dementia. Just that
we've found over the years patients who are in poor
health tend to develop that more than those who are
in good health. So that's why you can never get
away from eating your vegetables, limiting your sugars and starches,
and yes, being physically active. That stuff is gold or platinum,
(41:50):
whoever you talk to. That's really how you reduce your
chances of getting dementia. You got to eat the right food,
stay away from the wrong foods and beverages, and be
physically active. Stay involved, whether it be volunteering, talking to friends, family,
learning new skills. Don't sit around at home doing nothing,
(42:11):
not using your brain. That's not good. That can increase
risk of that as well. It's not all about that
one supplement you're taking. It's that lifestyle that feeds into that.
That's the one thing that I like to remind patients
that you can't just go down to the store buy
this man made product, start drinking it, taking it, eating it.
(42:35):
But you're not exercising, You're overweight, your sugars maybe not control,
your blood pressure is still high, you're not sleeping. It
doesn't work that way. I'm sorry. Got to put the
work in in order to get it out as you
get older. Have a good weekend, no drinking and driving.
We'll see you guys next week.
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