June 20, 2025 • 51 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 (00:01):
All right, welcome South East Texas into net radio listeners.
This is doc Levine, you know, a weekly host of
the Doctor Leavine Medical Hour.
Speaker 2 (00:10):
We are here live and the.
Speaker 1 (00:11):
Studios of kov I Hear Boma Text cross the street
from Parkdal. I'm all taking your phone calls and answering
questions about healthcare and medicine as we see it. Remember,
it's very confusing out there with all the information coming
towards you to decide what is good or what is
bad for you, or what should work and what shouldn't work,
(00:33):
and sometimes it's just not enough time at your healthcare
professional's office. Again, we're trying to get the best information
to you as a lot of the information coming to
you is unfiltered, not quite sure if the source of
the information. A lot of influencers out there where their
credentials are a little bit sketchy. You're not quite sure
(00:55):
what their background is or what their authority is that
allows them to give you that information. So it's just
never never can be too safe, and we're here to
try and clear that up, get you some answers so
that you can stay alive right as long as possible
and as healthy as possible. Without having to be hospitalized
(01:19):
or take a sack of mads every single day anyway,
phone lines are open eight nine six klv I one
one hundred three three zero Kovy.
Speaker 2 (01:29):
We always love to hear from you and chat and
see what's on your mind.
Speaker 1 (01:34):
On a nice, warm Saturday morning, and we get into
our summer months, as you know here in Southeast Texas,
it gets very very humid and very very hot, and
that can certainly bring its own issues. Who are already
starting to get into our dehydration issues just because of
(01:59):
the heat out there. Some people can't tolerate being out
in the heat, but sometimes your livelihood and your profession
requires you to be out in the heat. All of
the workers at the plants and just working on the
streets or home construction, you have to be out in
(02:20):
those elements every single day working on the road, and
sometimes that can be a problem with your body handling that.
Even though you're taking breaks and feel like you're staying
as hydrated as possible, just sometimes the heat is too
much and you start getting that cramping and nausea and
just that weakness, dizziness, maybe from the severe dehydration and
(02:45):
just the exposure of your body to the constant heat
and again the humanity. We have that heavy heat here
in southeast Texas, not that light heat that you might
get in California somewhere else in the United States, but
here in the Deep South. Man, it's heavy heat, like
a blanket of heat during the summer months. So it's
(03:10):
hard to tolerate that. As you know, I may not know.
I grew up here and it didn't seem to bother
me as much when I was young. But I'm older
in my fifties, and certainly, yes, I can feel that
heat now, and it is a little bit more cumbersome
to tolerate that.
Speaker 2 (03:28):
So you might have to be careful.
Speaker 1 (03:30):
And maybe if you want to cut that grass, and
or you want to exercise outside or be outside, you
may need to do it early in the morning about
this time, or later in the evening they say after
five or six o'clock as the sun is going down,
not necessarily in the middle of the day, like eleven
(03:51):
twelve one o'clock. That's in the middle of the day.
That's when it seems to be the hottest and the
most humid. And certainly, if you are vulnerable, maybe you
take medications such as diuretics. You all know them as
hydro chlorothisi chlorthalidome la six bumex torsomine. There is a
(04:13):
number of them out there. But if you have heart
conditions or kidney conditions that require you to be on
these diuretics, just because when you don't, you fill up
with fluid and then you get outside, you get exposed
to that heat and it further introduces some dehydration.
Speaker 2 (04:30):
It might cause a.
Speaker 1 (04:33):
Calamity of chain of events that ends up put you
in the hospital.
Speaker 2 (04:39):
So you have to be.
Speaker 1 (04:40):
Careful out there if you are taking a lot of
medications or you have a lot of medical issues. There
are websites you can go to that have some really
good information about how to stay cool as you get
as we get into the warmer parts of our year,
and sometimes these things that they recommend are very easy
(05:02):
to do. Sometimes a little bit more difficult, but it
all has to do with that exposure and trying to
stay out of that direct sunlight, that direct heat as
it heats up during the summer months. I prefer the
winter months, but certainly living here, you got to tolerate
(05:22):
that heat.
Speaker 2 (05:23):
And don't forget about the vaccines.
Speaker 1 (05:26):
You know, we do see viruses restaore viruses during the summer.
I know we think of the winter as sort of
our flu time, but we see flu throughout the year.
And we did do our taping of our acid Doc
segment yesterday and that was a question about COVID and
(05:46):
whether or not it was coming back. And my brief
answer to that is that COVID is here and we'll
always be here, and yes, just like the flu, there
might be some times where it's spikes and you might
see a lot of cases. This particular question was concerning
because several of their coworkers had gotten COVID recently, and
(06:12):
I was just wondering, Hey, what's going on with COVID
out there? Should we be concerned? Is there a spike
right now? And again, the pandemic was very emotional for everyone,
including myself. I mean, that was certainly a time that
I'd never experienced before, and we all have sort of
(06:32):
PTSD issues with COVID and certainly don't want to go
back to that. But in my humble opinion as a
healthcare provider, just don't think it can get back to
that point where things are shutting down and you're having
to wear masks, and quarantine and all this. What I'm
really expecting here in the next few years is really
(06:54):
a more relaxing of those efforts, just because again COVID
has really now become a resident virus in our community,
and because of just all the exposure and all the cases,
just our immunity has gotten to a point where it
(07:15):
can really sort of control the spread. And because most
people have been exposed, your reaction to that are the
severity I should say, I have an acute infection is
pretty low.
Speaker 2 (07:29):
It's not that high.
Speaker 1 (07:30):
It's pretty low, and normally don't end up in the hospital.
I mean, we're still seeing it, but it doesn't It's
really minimal in my experience, someone who's there in the
hospital each and every day taking care of Southeast Texans.
It's really at a minimum at this point. So I
really wouldn't be concerned about it.
Speaker 2 (07:51):
Again. You know, get your boosters. They say every six.
Speaker 1 (07:54):
Months, you know, go to your resource of getting vaccine.
So we still don't have them in the office yet.
They have to not release that to doctor's office as
far as I know, so you normally have to get
that from a pharmacy. They have really stepped up and
helped us administer those vaccines and sort of been the
(08:17):
main provider of vaccines here in the past several years,
offering that convenience. Go get your prescription medicine, Go get
a few groceries, and yeah, by the way, go get
your vaccine while you're walking through. And so they've sort
of taken over that aspect of it. So they have
(08:40):
those and every yeah, every six months for COVID is
what they're recommending at this point, especially if you have
a lot of medical issues.
Speaker 2 (08:48):
And again just reiterate.
Speaker 1 (08:51):
The way the vaccines work is just to keep the
severity down right. You can still get the infection, but
we're trying to keep the severity to a minimum so
that you can i'd have to be hospitalized to keep
that impulse or that exposure to a minimum so that
it doesn't tax your body too much. Again, we've talked
a lot about on this show just as we get older,
(09:14):
just our ability to tolerate acute medical stress is not
as great as when you're younger. Again, the more medical problems,
the more medications you take, your tolerance level goes down
in terms of acute medical trauma. That's what I'm calling it.
Acute infection of something that's medical trauma. Your body has
(09:37):
a severe reaction to it, and again if your body
is not in shape, then it's just hard to tolerate it.
And that's when you get weak, you throw up, you
can't eat, it's got to lay in bed, and may
have some injury to some of your other vital organs, kidneys, liver, brain.
I don't know if you've ever had a relative in
the hospital or you yourself have been in the hospital.
(09:59):
Sometimes you get that confusion that sets in. You don't
know where you are, you don't know who you are,
you don't know who your wife is, and you're maybe dizzy,
or you can't walk, or you can't swallow, and you
don't know what time it is, and maybe you're seeing things,
you're hearing things. We sort of get that admission to
(10:19):
the hospital frequently. We have a medical term for that,
which we call metabolic encephalopathy. But as we get older,
when we get sick, because of this systemic reaction to that,
it does not allow a nervous system to work very well.
So we get confused, and we get disoriented and maybe
(10:39):
even combative. You know, we fight more and we get
paranoid we hear things. So that's how a lot of
times these infections get cranking. When you have a pneumonia,
or you have a bladder infection, or any sort of
intradominal infection, when that response to the infection kicks in,
(11:00):
which we use the term sepsis scpsis. You have become
more familiar with that term over the past several years,
but that's a medical term we use when someone gets
a bad infection, normally bacterial, but viral infections can cause
it as well, just like a covid virus can cause that,
or the flu or any other.
Speaker 2 (11:22):
Virus out there.
Speaker 1 (11:23):
When that accepsis engine starts to kick up, you can
become very confused and disoriented. And that's a lot how
a lot of patients get to the hospital, honestly, is
that they have confusion set in and once we do
an evaluation, do blood work, or do X rays, we
discover that maybe they have a rip roaring urine a
(11:44):
tract infection, or they have a bad pneumonia, and that
is what is generating all of that confusion. And it's
scary to see that as a family member or a
wife or a husband. It's scary to see that just
because you're not quite sure what's going on, and this
is a brand new thing, could be mean a lot
of things. Certainly, strokes are always a possibility in those situations,
(12:08):
and most of the time when you bring someone to
a healthcare facility with that complaint, that confusion or disorientation
that we get into sometimes when we get sick and
we're elderly, they will consider stroke and normally do an
X ray of the head cat scan to look for
any evidence of that. But again they will do more
(12:31):
X rays like a chest X ray and urine test
and other basic lab work such as a CBC and
a CMP. And again, people are becoming more familiar with
these terms, just because most of the time at most
healthcare facilities now when you walk out, you go home,
or you get discharge, you're getting that information will packet
(12:55):
with some of that basic information and some of these
basic results that are in the packet. You're sort of
getting that there so that you can review it or
look at it, bring into your health care provider when
you go to the office, and within a week or so,
that's really what they want you to do. Anytime you
go into the hospital and you get discharged, they would
(13:17):
like you to follow up with your health care provider.
Within seven days is sort of the estimated time that
they want you to follow up, just to reassess you
and see how things are going, maybe review your medications,
do some follow up laboratory, make sure your confusion has
gotten better, You're pneumonia's better, you're breathing okay, you don't
(13:39):
need oxygen. Just because it's difficult to guarantee that once
you leave the hospital that you won't have to go back.
I hear that refrain all the time in the hospital
front patients and patience families. They don't want to have
to come back to the hospital too quick. They want
to stay as long as they need to so that
they don't have to come back in a short period
(14:01):
of time. And that is honestly the hospital's goal as well.
That's normally the goal of your treating provider, as well
as the multiple doctors that may have seen you there
in the hospital. That is their goal as well as
to keep you at home and try to prevent you
from coming back to the hospital too quickly because a
(14:23):
lot of times in case that your condition has gone backwards,
and sometimes there are identifiable issues that come up, but
a lot of times it's just the natural history of disease.
It's controlled at the time you discharge, but a few
days later, something happens and now the disease is now
(14:45):
back to where it started, and you have to come
back and get reassessed. And I certainly understand not wanting
to go back to the hospital. That's sort of a
cumbersome process to get to the er and get seen
by doctor and just all the testing. Man, it eats
up a lot of time, and it's very anxiety provoking
(15:07):
just because of all the mystery of what is happening,
and you seeing so many different providers. You're seeing nurses, doctors,
maybe X ray texts, just coming in and out of
the room, and so much to swallow when you're sick
or if it's something that you're not quite sure what's
(15:28):
going on. So we certainly get that and we want
to do what we can to try and make sure
that when you get home you have all the information
you need and then the proper follow up again, certainly
with a healthcare provider, just because there is a shortage
of healthcare providers out there, sometimes that is a problem
as well. Finding a person in the hospital, a provider
(15:51):
that can go to and get some follow up, someone
they can talk to. A lot of times we will
initiate what we call home health, where the person who's
being discharged will have sort of a healthcare provider, normally
a registered nurse, just to come out and check you out,
do some vitals, go over your med profile, do a
(16:12):
little quick physical exam, see how you're doing, and again
do some reassessment and see if there's anything that needs
to be done. Do you need an adjustment of your medicine,
do you need some lab Do you need to go
back to the hospital, all those sorts of things, just
because these situations can be very fluid and it's really
hard to predict a lot of times when you might
(16:34):
have to go back. But certainly getting reassessed is something
that I do promote or I do remind patients, no
matter if it's me or any other provider, it's my
office or someone's else's office, or even in the hospital.
If I discharge you in the hospital, something happens, you
need to be open minded and get reassessed for whatever
(16:58):
is going on. Just because we just cannot gat and
tee what's going to happen once you leave the hospital,
you have to have that position that if something happens,
I need to come back in and do some more
lab do some more X rays, maybe see a different
practitioner and get a fresh approach, see if they come
up with the same conclusion about what I have or
(17:20):
don't have or the way to treat it. Just because again,
these diseases are very tricky and these presentations can be
very confusing even for the most skilled or most veteran
healthcare provider. So you have to have an open mind
and certainly do your part to get reassessed if things
are not going as scheduled or as planned with your
(17:42):
symptoms or how you feel, that sort of thing. So certainly,
if you have any questions about that being hospitalized, discharge,
having to come back to the hospital, give us a
call phone lines or open eight done six kalva at
one one hundred and three to three zero kova.
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Sing to Doctor Levine's Medical Hour on News Talk five
sixty klv I To join the conversation, Call eight nine
six klv I Our eight hundred three three zero klv I.
Speaker 1 (20:35):
All right, welcome back to theography one of our phone
lines are open eight nine six K one eight hundred
and three three zero kl V. I here just chatting
about various topics or wait on phone calls. We did
have our taping of the ASCIDOCT segment yesterday and we
did have some topics. I thought I would introduce our
(20:57):
word on phone calls.
Speaker 2 (20:58):
We have Nick. How can we help you?
Speaker 11 (21:00):
Yes, yeah, good morning, Kendy.
Speaker 4 (21:02):
Morning.
Speaker 11 (21:03):
All right, sir.
Speaker 2 (21:03):
Absolutely, we can hear you. Well, what's going on this morning?
Speaker 11 (21:09):
Okay? I have an issue I need to.
Speaker 12 (21:12):
Ask you about. I have a condition. I have diarrhea,
but it's been going on for some time and I
am calling it long term diarrhea. And I wonder if
there is any medical significance or what do I.
Speaker 13 (21:29):
Need to worry about for I'm going on day thirty
five right now, sir, for diarrhea, and it's there's never
a lot of volume, but it is literally every day.
Speaker 1 (21:45):
Did you have any sort of evaluation by healthcare provider already?
Speaker 11 (21:51):
Not yet?
Speaker 12 (21:53):
I mean no pain, there's no discomfort or anything other
than just having to go to the bathroom four, five
or six times a day.
Speaker 1 (22:01):
Okay, and you've been doing that for about a month
so far I started.
Speaker 12 (22:05):
I remember it was Sunday morning, May eleventh, whenever it
first started, and I thought it was just perhaps just
another case of diarrhea coming on, But this one has
It hasn't changed, and there's no pain, there's no blood,
and there's no other items that I could that I
could search for so find. And I intend to go
(22:27):
to a physician, but I want to make sure I
understand what's going on also.
Speaker 1 (22:34):
Okay, so you haven't discovered anything that makes it better
or worse, just just you have it every day and
that's it.
Speaker 11 (22:46):
It's pretty regular.
Speaker 12 (22:48):
Usually this past thirty five days, I've I would say
half of those days, I've started my day off at
four or five o'clock in the morning with the problem
and it will take me through the day. The biggest
lapse period that I have is probably early morning before
noon up until about one or two o'clock in the afternoon,
(23:10):
and then sort of another cycle would come in.
Speaker 2 (23:16):
You haven't tried any over the counter medication.
Speaker 11 (23:19):
Not until I talk to someone like you.
Speaker 12 (23:21):
As I was thinking about, why don't I just take
some milky magnesia, you know, evacuate my colon to start
all over?
Speaker 11 (23:29):
Yeah, And see what happens. But maybe I don't want
to do that.
Speaker 2 (23:32):
I don't know. Yeah, any medical issues.
Speaker 12 (23:34):
You have, No, there's nothing recent. I've had my checked
ups most of the time this year. I just had
my urology and prostate exam this past week and they
say everything's.
Speaker 2 (23:47):
Fine, and you don't take any medications.
Speaker 11 (23:51):
Well, I will.
Speaker 12 (23:51):
I take prescription drugs for blood pressure and prostate. Nothing new,
nothing new, no, sir?
Speaker 1 (24:00):
Okay, Yeah, Nick, I think that this would be categorized
as a chronic diarrhea just because it has lasted beyond
a couple of weeks. We have a lot of what
we call acute diarrhea, which means, just like you said,
it starts up and it's brand new, you've never had
(24:20):
it before. But normally acute diarrhea of subsides within a
week or so. Normally, if it goes beyond two weeks
and it's sort of persistent and the amount of bile
habits you're having per day remain the same, we kind
of kick it to what we call a chronic diarrhea.
And yes, it would be a good idea in my opinion,
(24:43):
to initiate an evaluation that normally will revolve around a
lot of blood work. Stool studies what we call that
meaning we analyze the character of the stool to see
if we can identify any think about your stool that
can help us diagnos why you're having so much loose stool.
Speaker 2 (25:05):
And then we would do some X.
Speaker 1 (25:07):
Rays, typically a cat scan of your abdomen and pelvis,
as well as what we call endoscopic evaluation. That's when
you go to gashoentrologist and they use their endoscopes to
look inside your colon, look inside your upper GI track
again searching for clues to figure out, you know, why
(25:29):
you're having a loose stool.
Speaker 12 (25:32):
Okay, let me share one thing with you, doctor Levine.
I went through all the tests and ever was saying,
I've sort of had a this condition where it's head
about thirteen or fourteen months ago.
Speaker 11 (25:50):
And I went through all the lab testing.
Speaker 12 (25:53):
I have the colonoscophy, I have the front or the
upper colonoscopy in the GI track, and everything was considered fine.
Speaker 11 (26:04):
They said you're good to go. Everything let's looks fine.
And it it.
Speaker 12 (26:11):
Didn't go thirty five days the last time, but it
went a couple of weeks.
Speaker 2 (26:16):
And did they give you any medication.
Speaker 11 (26:19):
No, sir, they told me to take Oh what's the uh.
Speaker 12 (26:27):
Orange power did you take to help your ball mules?
Speaker 11 (26:32):
To take that every day? And I took that every day.
Speaker 2 (26:35):
Okay, So.
Speaker 12 (26:38):
But no, I did go through through all the UH
well it was a significant test, I think, the last
the lab workout and the UH the other procedures.
Speaker 11 (26:48):
So, but that was a year ago. I was in
March of twenty four.
Speaker 2 (26:53):
Yes, sir, yes, correct.
Speaker 1 (26:55):
So the thing about these diseases is that they don't
all present themselves in a very classic presentation, and sometimes
even though you did have an appropriate workup, we don't
find anything at that time. The idea, and I've mentioned
this before in the show, is you have to have
(27:18):
an open mind about getting reevaluated. And I think that's
what you need to do, is to get re evaluated.
And a lot of times we will run those same
tests just because sometimes it doesn't show up initially, but
with repeated episodes and with repeated testing, it will then
show up whatever it's causing it, and then you get
(27:39):
your diagnosis. For most people, yes, any acute medical physical problem,
you go to your healthcare provider, they run some tests,
you get diagnosed. It works out for most right fat
percentage of the time, maybe eighty nine percent of the time.
With any sort of encounter with a healthcare provider, you
(28:00):
get the right diagnoses, But there is a small percentage
of those encounters where we don't know what's wrong or
the testing is negative, and it's frustrating for the patient
as well as a physician. I mean, obviously we want
to be successful each time we do an evaluation for
an acute problem, but we just are not able to
(28:23):
do that every single encounter. So what I have advised
patients now that I've been a physician for over twenty.
Speaker 2 (28:30):
Years, you have to get reassessed, and.
Speaker 1 (28:33):
You can go to the same doctor because they know you,
they have all your information, and they're familiar with your case.
But most of the time, we repeat those labs, we
repeat that scope, we repeat the scan again to see
if we overlooked anything or maybe something wasn't showing up.
Speaker 2 (28:52):
That's what you have to do.
Speaker 12 (28:55):
Okay, there's since I sort of had an introduction to
this back in twenty twenty four after my colonoscopy and
the other labor all the lab work on the colonoscopy
working whatever goes with that I was essentially dormous then
for a year, and then it just rears its head again.
(29:17):
Is that Does that unusual for a condition?
Speaker 11 (29:21):
Not necessarily, No, I'm talking about.
Speaker 1 (29:23):
No, No, it is not. Sometimes these conditions are intermittent.
They come and go as a matter of fact, so
it's not unusual. Again, we try to drive best to
hit a home run on the first encounter, but unfortunately
we're not always able to do that, and you have
(29:45):
to just get reassessed and run those same examinations, and
a lot of times on the second or even.
Speaker 2 (29:51):
Third wave of evaluation it gets discovered.
Speaker 1 (29:55):
At least that's been my experience with these sort of
undinoicable medical issues, that these diseases sort of become more advanced,
and the more advanced they get, it gets easier to diagnosed,
in my honest opinion, just because you get more physical
symptoms and the clinician is able to see the evidence
(30:17):
that they need to make a diagnosis, just because sometimes
initially it's unclear. It's a lot of things that can
cause diarrhea, and there's a process of elimination they go
through to try and figure out which one it is.
So with each evaluation they get better and closer and
more precise about what it is or it's not. But
(30:40):
you have to have the stamina to say to yourself, Okay, I'm.
Speaker 2 (30:45):
Going to go in.
Speaker 1 (30:46):
I know it's going to be time consuming, it's still cumbersome,
but I want to get to the bottom of it.
So you just have to dig in and allow the
clinician to go through their process elimination, maybe try some
different medications to get things under control. We normally, in
my experience, can get diarrheal illnesses controlled and diagnosed to
(31:07):
the point where it's not bothering you all day.
Speaker 2 (31:10):
We rule out a.
Speaker 1 (31:12):
Lot of significant pathology, you know, significant things like pink
ratic cancer, colon cancer, significant bowel inflammation like Crohn's disease.
These are some things that can cause diarrhea. So we
get a lot of that heavy hitter stuff out of
the way. And sometimes, yes we're at the end of
(31:32):
the day, we don't know, but we can get you
on a medication that might slow that down, and that
might be the goal for right now, just to kind
of get control over your bowel function. So but I think, yeah,
you need to get reevaluated, no question.
Speaker 12 (31:49):
I'll go in early next week. And ask for them,
tell them the science signed me up again.
Speaker 1 (31:56):
Yeah, and hey, Nick, give us a callback and let
us know what happened and what they came up with this.
Speaker 12 (32:05):
Have you ever heard or had a patient that has
had the chronicreer?
Speaker 1 (32:10):
Oh? Yeah, absolutely, it's very common. It's very common, very common. Yes, absolutely,
So we see it often. It's frustrating, but like I said,
normally we can get it calm down. There are several
medications that you can take daily that can keep the
volume of stool to a controllable amount so that you're
(32:34):
not in the restroom all day long. You can go
to the restaurant, you can travel, you can go to work.
We can normally find something that can slow that down
so that it's not interfering with your lifestyle.
Speaker 2 (32:47):
So but yeah, I just got to get reevaluated. All right, Nick?
Speaker 14 (32:56):
All right?
Speaker 2 (32:56):
We appreciate Nick's call chronic diarrhea. Who wants that? Right?
Speaker 1 (33:00):
But we see it a lot of phone lines open
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Portions of the following program where we recorded This is
No on Ryan coming to you from the American Standard
are dot Com Studios with news Talk five sixty klv I.
You are listening to Doctor Levine's Medical Hour on news
Talk five sixty KLVII. To join the conversation, call eight
nine six klv I are eight hundred three three zero
(36:30):
klv I.
Speaker 1 (36:41):
All right, Welcome back to the Doctor Dmclour phone lines
are open eight nine six kV I one one hundred
three three zero kov I talking about various talks, including diarrhea.
Last call on that we all have a periodically some
change in our bowel habits. One thing that Americans suffer
the most, in my opinion, is constipation. However, that's sort
(37:04):
of an opposite experience. You're going several days without eliminating,
and that is a huge problem in our country, primarily
just because of our lifestyle choices.
Speaker 2 (37:19):
To big reasons for that.
Speaker 1 (37:20):
Inactivity breeds a slowing down of your bowel activity, as
well as the types of foods that we eat, and unfortunately,
most of us are eating foods that do not contain
a lot of fiber, just because most of the time
we're eating processed foods, and processed foods tend to have
(37:43):
a low fiber presence, and so you're sort of eating
things that do not promote good and bowel health. And
then we're inactive. So that combination a lot of times
will generate constipation. And there's a whole host of medications
over the counter that help with constipation.
Speaker 2 (38:05):
A lot of them are very good, they're safe.
Speaker 1 (38:08):
The most popular over the counter is called mer Relax.
Mr Lax comes in a powder typically and you basically
pour it in whatever liquid that you're drinking, and you
have a couple of those mer relax maybe twice a day,
three times a day, once a day, every other day.
Speaker 2 (38:31):
It doesn't matter.
Speaker 1 (38:31):
Everybody's different, but basically it does introduce a increased frequency
of your bowel habit, so that you're eliminating maybe once
a day or every other day. Believe it or not,
some people go several days, four or five days without eliminating,
even though they're eating every single day. Remember, a body
is in balance, right. Homeostasis is the name for that,
(38:55):
and it's trying to achieve that every single day, so
that if you're eating every you should be eliminating every day,
just like you urinate every day, and if you don't,
that's a concern that normally generates i'm sorry, or indicates
an imbalance. Maybe something's wrong with your bladder, maybe something's
wrong with your kidneys.
Speaker 2 (39:15):
You should be.
Speaker 1 (39:16):
Alarmed if you go all day and you haven't had
any urination, especially if you are drinking every single day.
We sort of get into that during the summer months, right,
just because dehydration can generate some i'm sorry, exposure to
heat can generate some dehydration that can decrease your your
(39:37):
bowel flow, I'm sorry, your urine flow if you're not
drinking a lot. But certainly constipation would be the biggest issue,
and changing your diets certainly would help. You know, heating
more fiber. Again, vegetables has a lot of fiber in it.
Nuts and seeds that has good fiber. Whole grains has
(39:58):
good fiber like flag see quene, wab buckwheat, millet, barley oats.
You know that those have a lot of fiber content
in them, and you can eat those in various different ways.
But certainly if you're eating frozen food or prepackaged food,
or you're eating at the fast food restaurants, a lot
(40:19):
of times the fiber is not there. And so if
you're eating that every single day, and then maybe work
at a job where you're not moving around as much
and you're sedentary throughout the day, then that can also
generate its own inactivity and just some of that combination
will cause that constipation issue. But there's the medication relax
(40:43):
is there available for you over the counter. You don't
even have to get a prescription, but there's several prescription
medications that we write for that work really well. Also
that doctors have and they're typically benign, they're not very toxic,
and you can take these medications lifelong. Anybody who's ever
(41:05):
started exercising, that's one thing that they always say is
that normally their bow habits return back to normal pretty quickly.
If you've ever been hospitalized or sick and you know,
you start sitting more, you laying down in the bed more,
that's one thing that happens is your bowel function slows
down pretty drastically. So just again an imbalance with that.
(41:27):
But again we'll get into that diar real issue, and
it normally requires a bunch of lab work. We normally
will test the stool for various elements, whether or not
there's infection in it or certain components in it that
will trying to help us figure out why you're having
such loose stool. And then we look at We certainly
(41:47):
do a cat scan because we want to look at
the gas intestinal system, especially if it's generating all these
bowel habits, want to see if it looks abnormal, does
the lining of the intestine look inflamed, is there sort
of some obstruction, Is there something wrong with your painkers
because it's involved with your digestive system as well. And
(42:10):
again just to look around and see if we can
find anything abnormal. And then the GI doctors will do
their scopes again just to look inside and see if
there's something there that might be mysterious and help us
figure that out. But always be open minded to get
reassessed no matter what physical complaint that you have. If
you were given some prescription medications and you got your
(42:33):
discharge paperwork and they gave your diagnosis, everything sort of
makes sense. But three days later you don't feel good,
you feel worse, maybe the symptoms are not improving.
Speaker 2 (42:43):
Got to go back in.
Speaker 1 (42:44):
You know, even to the same practitioner, different practitioner, and
sort of get another evaluation. A lot of times the
same tests will be repeated, just because sometimes it's not
clear initially, but on follow up it's very obvious what's happening.
And then the medication get cary a changed, and then
you get the right diagnosis and then you get better.
(43:06):
But you have to keep an open mind about that
when it comes to that. Phone lines are open eight
nine to six Scalvy I won one hundred three to
three zero.
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Speaker 3 (45:16):
You're listening to Doctor Levine's Medical Hour on news Talk
five sixty KLVII. To join the conversation, call eight nine
six klv I. Are eight hundred three three zero klv I.
Speaker 2 (45:41):
All right, welcome back to talk with the own line.
Leonard from GUS and I can we help you real quick?
Speaker 5 (45:48):
I'm calling texture with my diabetes. Sometimes when I'm driving
or sitting watching TV, it's feels like it's probably sticking
me in the foot with us eyespeak or something. What
do I do about that?
Speaker 1 (46:00):
Well, you know, litter as you know, you've had diabetes
for some time, and one of the issues that comes
up with diabetes sometimes is neuropathy or nerve injury, and
one of the symptoms of that is sort of a
numbness or tingling of the feet, and it can be
kind of painful. So most of the time that is
(46:21):
the cause of that, and you know, there's medications that
can be prescribed to you, but certainly foot care and
foot hygiene is very important for diabetic patients. As you
can get circulatory problems, you can get ulcers on the
foot that can then generate pain. You can get infections
(46:43):
such as osteomolitis that's infection of the bone.
Speaker 2 (46:47):
So a lot of.
Speaker 1 (46:47):
Times for diabetics, we advise that they examine their feet
on a regular basis, they see a pediatrist on a
regular basis just to get a good exam. But certainly
if you're having pain, are some discomfort of your foot,
then you have diabetes. Certainly, you know, look at it
yourself and see if you can see anything. But if
you can't, you might need some X rays such as
(47:10):
a plain X ray, you might need some studies on
your circulation.
Speaker 2 (47:15):
And yeah, to go buy and see the pediatris.
Speaker 1 (47:18):
Let them do an examination, make sure everything is intact,
make sure you don't have needles or foreign bodies stuck
in your skin of your foot. We see that all
the time with diabetics who have neuropathy. They come into
the er or the office and there's a big needle
sticking in their foot and that's been there for maybe
two weeks and it's infected. So yeah, if really, if
(47:42):
you have pain and discomfort and it doesn't go away,
just need to get checked out and make sure nothing
is going wrong.
Speaker 5 (47:49):
Okay, well I have a foot doctor, I'll go seeing.
But it's been I've had it for years, so it's
not a it's not a short term thing.
Speaker 1 (47:59):
Yeah, So probably it's something that's you've had and nothing
to worry about and probably related to a little neuropathy
there in your foot, just because the years of the
diabetes and you know nothing to worry about, especially if
you've already had it checked out and maybe you're on
some medication. But every now and then it might spike
(48:20):
for unknown reasons. That's just the way neuropathy is. But yeah,
if it's new, you certainly get it checked out. But
if it's old, maybe you can just get by and
reassure yourself.
Speaker 2 (48:31):
Just look at your foot and make sure it's okay.
Speaker 5 (48:34):
Is there an exercise or stretching things that I should do.
Speaker 2 (48:40):
For that particular problem.
Speaker 1 (48:42):
I'm unaware of any sort of physical therapy or stretching
that you can do to alleviate that, No, sir. Sometimes
you can get what they call a plantar fasciiis, which
is like an inflammatory condition of the tendon of the
bottom of the foot, and there are physical therapy exercise
that can do the involve stretching to help with that.
(49:05):
That can certainly generate pain in your foot. So that's
the reason to go to the paediats. Let them do
a reassessment and see if it's your neueropathy or if
it's something new. They have exercises for that, But just
for plano neuopathy, I don't know if any exercises that
can be done though.
Speaker 5 (49:22):
Sir okay, well thanks for guy all right learning.
Speaker 1 (49:26):
We appreciate that comment, and yes, if you do have
dabites type one or type two, we certainly recommend some
foot hygiene and we want you to examine your feet
at once a day or maybe once a week, and
certainly go by the pedotris maybe once a year.
Speaker 2 (49:43):
Let them take a look at everything.
Speaker 1 (49:45):
And the idea is that if you can't control the
sugar in your bloodstream, it normally doesn't cause any problems
with your feed but certainly if you start developing that,
go in and get that checked out, as it can
escalate to some pretty serious issues abscesses and infections, sometimes
unfortunately amputations of toes or the foot itself or the
(50:08):
little extremity. So the stuff can get pretty intense. But
it all falls back on knowing your numbers and keeping
the sugar, cholesterol and blood pressure down and that starts
with that lifestyle, right, eating the healthy diet and staying
away from the sugar. Anyway, we appreciate all of the
listeners and the phone callers. Don't drink and drive happy
(50:28):
father say that all the father's out there.
Speaker 2 (50:30):
We'll see you guys next week.
Speaker 14 (50:31):
Take care.
Speaker 4 (51:13):
Number one on your car radio precent, and then you
would improved iHeartRadio app.
Speaker 3 (51:18):
This is used Heart five sixty klv I Beaumont Free.
Speaker 2 (51:22):
Never sounded so good.
All right, welcome South East Texas into net radio listeners.
This is doc Levine, you know, a weekly host of
the Doctor Leavine Medical Hour.
Speaker 2 (00:10):
We are here live and the.
Speaker 1 (00:11):
Studios of kov I Hear Boma Text cross the street
from Parkdal. I'm all taking your phone calls and answering
questions about healthcare and medicine as we see it. Remember,
it's very confusing out there with all the information coming
towards you to decide what is good or what is
bad for you, or what should work and what shouldn't work,
(00:33):
and sometimes it's just not enough time at your healthcare
professional's office. Again, we're trying to get the best information
to you as a lot of the information coming to
you is unfiltered, not quite sure if the source of
the information. A lot of influencers out there where their
credentials are a little bit sketchy. You're not quite sure
(00:55):
what their background is or what their authority is that
allows them to give you that information. So it's just
never never can be too safe, and we're here to
try and clear that up, get you some answers so
that you can stay alive right as long as possible
and as healthy as possible. Without having to be hospitalized
(01:19):
or take a sack of mads every single day anyway,
phone lines are open eight nine six klv I one
one hundred three three zero Kovy.
Speaker 2 (01:29):
We always love to hear from you and chat and
see what's on your mind.
Speaker 1 (01:34):
On a nice, warm Saturday morning, and we get into
our summer months, as you know here in Southeast Texas,
it gets very very humid and very very hot, and
that can certainly bring its own issues. Who are already
starting to get into our dehydration issues just because of
(01:59):
the heat out there. Some people can't tolerate being out
in the heat, but sometimes your livelihood and your profession
requires you to be out in the heat. All of
the workers at the plants and just working on the
streets or home construction, you have to be out in
(02:20):
those elements every single day working on the road, and
sometimes that can be a problem with your body handling that.
Even though you're taking breaks and feel like you're staying
as hydrated as possible, just sometimes the heat is too
much and you start getting that cramping and nausea and
just that weakness, dizziness, maybe from the severe dehydration and
(02:45):
just the exposure of your body to the constant heat
and again the humanity. We have that heavy heat here
in southeast Texas, not that light heat that you might
get in California somewhere else in the United States, but
here in the Deep South. Man, it's heavy heat, like
a blanket of heat during the summer months. So it's
(03:10):
hard to tolerate that. As you know, I may not know.
I grew up here and it didn't seem to bother
me as much when I was young. But I'm older
in my fifties, and certainly, yes, I can feel that
heat now, and it is a little bit more cumbersome
to tolerate that.
Speaker 2 (03:28):
So you might have to be careful.
Speaker 1 (03:30):
And maybe if you want to cut that grass, and
or you want to exercise outside or be outside, you
may need to do it early in the morning about
this time, or later in the evening they say after
five or six o'clock as the sun is going down,
not necessarily in the middle of the day, like eleven
(03:51):
twelve one o'clock. That's in the middle of the day.
That's when it seems to be the hottest and the
most humid. And certainly, if you are vulnerable, maybe you
take medications such as diuretics. You all know them as
hydro chlorothisi chlorthalidome la six bumex torsomine. There is a
(04:13):
number of them out there. But if you have heart
conditions or kidney conditions that require you to be on
these diuretics, just because when you don't, you fill up
with fluid and then you get outside, you get exposed
to that heat and it further introduces some dehydration.
Speaker 2 (04:30):
It might cause a.
Speaker 1 (04:33):
Calamity of chain of events that ends up put you
in the hospital.
Speaker 2 (04:39):
So you have to be.
Speaker 1 (04:40):
Careful out there if you are taking a lot of
medications or you have a lot of medical issues. There
are websites you can go to that have some really
good information about how to stay cool as you get
as we get into the warmer parts of our year,
and sometimes these things that they recommend are very easy
(05:02):
to do. Sometimes a little bit more difficult, but it
all has to do with that exposure and trying to
stay out of that direct sunlight, that direct heat as
it heats up during the summer months. I prefer the
winter months, but certainly living here, you got to tolerate
(05:22):
that heat.
Speaker 2 (05:23):
And don't forget about the vaccines.
Speaker 1 (05:26):
You know, we do see viruses restaore viruses during the summer.
I know we think of the winter as sort of
our flu time, but we see flu throughout the year.
And we did do our taping of our acid Doc
segment yesterday and that was a question about COVID and
(05:46):
whether or not it was coming back. And my brief
answer to that is that COVID is here and we'll
always be here, and yes, just like the flu, there
might be some times where it's spikes and you might
see a lot of cases. This particular question was concerning
because several of their coworkers had gotten COVID recently, and
(06:12):
I was just wondering, Hey, what's going on with COVID
out there? Should we be concerned? Is there a spike
right now? And again, the pandemic was very emotional for everyone,
including myself. I mean, that was certainly a time that
I'd never experienced before, and we all have sort of
(06:32):
PTSD issues with COVID and certainly don't want to go
back to that. But in my humble opinion as a
healthcare provider, just don't think it can get back to
that point where things are shutting down and you're having
to wear masks, and quarantine and all this. What I'm
really expecting here in the next few years is really
(06:54):
a more relaxing of those efforts, just because again COVID
has really now become a resident virus in our community,
and because of just all the exposure and all the cases,
just our immunity has gotten to a point where it
(07:15):
can really sort of control the spread. And because most
people have been exposed, your reaction to that are the
severity I should say, I have an acute infection is
pretty low.
Speaker 2 (07:29):
It's not that high.
Speaker 1 (07:30):
It's pretty low, and normally don't end up in the hospital.
I mean, we're still seeing it, but it doesn't It's
really minimal in my experience, someone who's there in the
hospital each and every day taking care of Southeast Texans.
It's really at a minimum at this point. So I
really wouldn't be concerned about it.
Speaker 2 (07:51):
Again. You know, get your boosters. They say every six.
Speaker 1 (07:54):
Months, you know, go to your resource of getting vaccine.
So we still don't have them in the office yet.
They have to not release that to doctor's office as
far as I know, so you normally have to get
that from a pharmacy. They have really stepped up and
helped us administer those vaccines and sort of been the
(08:17):
main provider of vaccines here in the past several years,
offering that convenience. Go get your prescription medicine, Go get
a few groceries, and yeah, by the way, go get
your vaccine while you're walking through. And so they've sort
of taken over that aspect of it. So they have
(08:40):
those and every yeah, every six months for COVID is
what they're recommending at this point, especially if you have
a lot of medical issues.
Speaker 2 (08:48):
And again just reiterate.
Speaker 1 (08:51):
The way the vaccines work is just to keep the
severity down right. You can still get the infection, but
we're trying to keep the severity to a minimum so
that you can i'd have to be hospitalized to keep
that impulse or that exposure to a minimum so that
it doesn't tax your body too much. Again, we've talked
a lot about on this show just as we get older,
(09:14):
just our ability to tolerate acute medical stress is not
as great as when you're younger. Again, the more medical problems,
the more medications you take, your tolerance level goes down
in terms of acute medical trauma. That's what I'm calling it.
Acute infection of something that's medical trauma. Your body has
(09:37):
a severe reaction to it, and again if your body
is not in shape, then it's just hard to tolerate it.
And that's when you get weak, you throw up, you
can't eat, it's got to lay in bed, and may
have some injury to some of your other vital organs, kidneys, liver, brain.
I don't know if you've ever had a relative in
the hospital or you yourself have been in the hospital.
(09:59):
Sometimes you get that confusion that sets in. You don't
know where you are, you don't know who you are,
you don't know who your wife is, and you're maybe dizzy,
or you can't walk, or you can't swallow, and you
don't know what time it is, and maybe you're seeing things,
you're hearing things. We sort of get that admission to
(10:19):
the hospital frequently. We have a medical term for that,
which we call metabolic encephalopathy. But as we get older,
when we get sick, because of this systemic reaction to that,
it does not allow a nervous system to work very well.
So we get confused, and we get disoriented and maybe
(10:39):
even combative. You know, we fight more and we get
paranoid we hear things. So that's how a lot of
times these infections get cranking. When you have a pneumonia,
or you have a bladder infection, or any sort of
intradominal infection, when that response to the infection kicks in,
(11:00):
which we use the term sepsis scpsis. You have become
more familiar with that term over the past several years,
but that's a medical term we use when someone gets
a bad infection, normally bacterial, but viral infections can cause
it as well, just like a covid virus can cause that,
or the flu or any other.
Speaker 2 (11:22):
Virus out there.
Speaker 1 (11:23):
When that accepsis engine starts to kick up, you can
become very confused and disoriented. And that's a lot how
a lot of patients get to the hospital, honestly, is
that they have confusion set in and once we do
an evaluation, do blood work, or do X rays, we
discover that maybe they have a rip roaring urine a
(11:44):
tract infection, or they have a bad pneumonia, and that
is what is generating all of that confusion. And it's
scary to see that as a family member or a
wife or a husband. It's scary to see that just
because you're not quite sure what's going on, and this
is a brand new thing, could be mean a lot
of things. Certainly, strokes are always a possibility in those situations,
(12:08):
and most of the time when you bring someone to
a healthcare facility with that complaint, that confusion or disorientation
that we get into sometimes when we get sick and
we're elderly, they will consider stroke and normally do an
X ray of the head cat scan to look for
any evidence of that. But again they will do more
(12:31):
X rays like a chest X ray and urine test
and other basic lab work such as a CBC and
a CMP. And again, people are becoming more familiar with
these terms, just because most of the time at most
healthcare facilities now when you walk out, you go home,
or you get discharge, you're getting that information will packet
(12:55):
with some of that basic information and some of these
basic results that are in the packet. You're sort of
getting that there so that you can review it or
look at it, bring into your health care provider when
you go to the office, and within a week or so,
that's really what they want you to do. Anytime you
go into the hospital and you get discharged, they would
(13:17):
like you to follow up with your health care provider.
Within seven days is sort of the estimated time that
they want you to follow up, just to reassess you
and see how things are going, maybe review your medications,
do some follow up laboratory, make sure your confusion has
gotten better, You're pneumonia's better, you're breathing okay, you don't
(13:39):
need oxygen. Just because it's difficult to guarantee that once
you leave the hospital that you won't have to go back.
I hear that refrain all the time in the hospital
front patients and patience families. They don't want to have
to come back to the hospital too quick. They want
to stay as long as they need to so that
they don't have to come back in a short period
(14:01):
of time. And that is honestly the hospital's goal as well.
That's normally the goal of your treating provider, as well
as the multiple doctors that may have seen you there
in the hospital. That is their goal as well as
to keep you at home and try to prevent you
from coming back to the hospital too quickly because a
(14:23):
lot of times in case that your condition has gone backwards,
and sometimes there are identifiable issues that come up, but
a lot of times it's just the natural history of disease.
It's controlled at the time you discharge, but a few
days later, something happens and now the disease is now
(14:45):
back to where it started, and you have to come
back and get reassessed. And I certainly understand not wanting
to go back to the hospital. That's sort of a
cumbersome process to get to the er and get seen
by doctor and just all the testing. Man, it eats
up a lot of time, and it's very anxiety provoking
(15:07):
just because of all the mystery of what is happening,
and you seeing so many different providers. You're seeing nurses, doctors,
maybe X ray texts, just coming in and out of
the room, and so much to swallow when you're sick
or if it's something that you're not quite sure what's
(15:28):
going on. So we certainly get that and we want
to do what we can to try and make sure
that when you get home you have all the information
you need and then the proper follow up again, certainly
with a healthcare provider, just because there is a shortage
of healthcare providers out there, sometimes that is a problem
as well. Finding a person in the hospital, a provider
(15:51):
that can go to and get some follow up, someone
they can talk to. A lot of times we will
initiate what we call home health, where the person who's
being discharged will have sort of a healthcare provider, normally
a registered nurse, just to come out and check you out,
do some vitals, go over your med profile, do a
(16:12):
little quick physical exam, see how you're doing, and again
do some reassessment and see if there's anything that needs
to be done. Do you need an adjustment of your medicine,
do you need some lab Do you need to go
back to the hospital, all those sorts of things, just
because these situations can be very fluid and it's really
hard to predict a lot of times when you might
(16:34):
have to go back. But certainly getting reassessed is something
that I do promote or I do remind patients, no
matter if it's me or any other provider, it's my
office or someone's else's office, or even in the hospital.
If I discharge you in the hospital, something happens, you
need to be open minded and get reassessed for whatever
(16:58):
is going on. Just because we just cannot gat and
tee what's going to happen once you leave the hospital,
you have to have that position that if something happens,
I need to come back in and do some more
lab do some more X rays, maybe see a different
practitioner and get a fresh approach, see if they come
up with the same conclusion about what I have or
(17:20):
don't have or the way to treat it. Just because again,
these diseases are very tricky and these presentations can be
very confusing even for the most skilled or most veteran
healthcare provider. So you have to have an open mind
and certainly do your part to get reassessed if things
are not going as scheduled or as planned with your
(17:42):
symptoms or how you feel, that sort of thing. So certainly,
if you have any questions about that being hospitalized, discharge,
having to come back to the hospital, give us a
call phone lines or open eight done six kalva at
one one hundred and three to three zero kova.
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Sing to Doctor Levine's Medical Hour on News Talk five
sixty klv I To join the conversation, Call eight nine
six klv I Our eight hundred three three zero klv I.
Speaker 1 (20:35):
All right, welcome back to theography one of our phone
lines are open eight nine six K one eight hundred
and three three zero kl V. I here just chatting
about various topics or wait on phone calls. We did
have our taping of the ASCIDOCT segment yesterday and we
did have some topics. I thought I would introduce our
(20:57):
word on phone calls.
Speaker 2 (20:58):
We have Nick. How can we help you?
Speaker 11 (21:00):
Yes, yeah, good morning, Kendy.
Speaker 4 (21:02):
Morning.
Speaker 11 (21:03):
All right, sir.
Speaker 2 (21:03):
Absolutely, we can hear you. Well, what's going on this morning?
Speaker 11 (21:09):
Okay? I have an issue I need to.
Speaker 12 (21:12):
Ask you about. I have a condition. I have diarrhea,
but it's been going on for some time and I
am calling it long term diarrhea. And I wonder if
there is any medical significance or what do I.
Speaker 13 (21:29):
Need to worry about for I'm going on day thirty
five right now, sir, for diarrhea, and it's there's never
a lot of volume, but it is literally every day.
Speaker 1 (21:45):
Did you have any sort of evaluation by healthcare provider already?
Speaker 11 (21:51):
Not yet?
Speaker 12 (21:53):
I mean no pain, there's no discomfort or anything other
than just having to go to the bathroom four, five
or six times a day.
Speaker 1 (22:01):
Okay, and you've been doing that for about a month
so far I started.
Speaker 12 (22:05):
I remember it was Sunday morning, May eleventh, whenever it
first started, and I thought it was just perhaps just
another case of diarrhea coming on, But this one has
It hasn't changed, and there's no pain, there's no blood,
and there's no other items that I could that I
could search for so find. And I intend to go
(22:27):
to a physician, but I want to make sure I
understand what's going on also.
Speaker 1 (22:34):
Okay, so you haven't discovered anything that makes it better
or worse, just just you have it every day and
that's it.
Speaker 11 (22:46):
It's pretty regular.
Speaker 12 (22:48):
Usually this past thirty five days, I've I would say
half of those days, I've started my day off at
four or five o'clock in the morning with the problem
and it will take me through the day. The biggest
lapse period that I have is probably early morning before
noon up until about one or two o'clock in the afternoon,
(23:10):
and then sort of another cycle would come in.
Speaker 2 (23:16):
You haven't tried any over the counter medication.
Speaker 11 (23:19):
Not until I talk to someone like you.
Speaker 12 (23:21):
As I was thinking about, why don't I just take
some milky magnesia, you know, evacuate my colon to start
all over?
Speaker 11 (23:29):
Yeah, And see what happens. But maybe I don't want
to do that.
Speaker 2 (23:32):
I don't know. Yeah, any medical issues.
Speaker 12 (23:34):
You have, No, there's nothing recent. I've had my checked
ups most of the time this year. I just had
my urology and prostate exam this past week and they
say everything's.
Speaker 2 (23:47):
Fine, and you don't take any medications.
Speaker 11 (23:51):
Well, I will.
Speaker 12 (23:51):
I take prescription drugs for blood pressure and prostate. Nothing new,
nothing new, no, sir?
Speaker 1 (24:00):
Okay, Yeah, Nick, I think that this would be categorized
as a chronic diarrhea just because it has lasted beyond
a couple of weeks. We have a lot of what
we call acute diarrhea, which means, just like you said,
it starts up and it's brand new, you've never had
(24:20):
it before. But normally acute diarrhea of subsides within a
week or so. Normally, if it goes beyond two weeks
and it's sort of persistent and the amount of bile
habits you're having per day remain the same, we kind
of kick it to what we call a chronic diarrhea.
And yes, it would be a good idea in my opinion,
(24:43):
to initiate an evaluation that normally will revolve around a
lot of blood work. Stool studies what we call that
meaning we analyze the character of the stool to see
if we can identify any think about your stool that
can help us diagnos why you're having so much loose stool.
Speaker 2 (25:05):
And then we would do some X.
Speaker 1 (25:07):
Rays, typically a cat scan of your abdomen and pelvis,
as well as what we call endoscopic evaluation. That's when
you go to gashoentrologist and they use their endoscopes to
look inside your colon, look inside your upper GI track
again searching for clues to figure out, you know, why
(25:29):
you're having a loose stool.
Speaker 12 (25:32):
Okay, let me share one thing with you, doctor Levine.
I went through all the tests and ever was saying,
I've sort of had a this condition where it's head
about thirteen or fourteen months ago.
Speaker 11 (25:50):
And I went through all the lab testing.
Speaker 12 (25:53):
I have the colonoscophy, I have the front or the
upper colonoscopy in the GI track, and everything was considered fine.
Speaker 11 (26:04):
They said you're good to go. Everything let's looks fine.
And it it.
Speaker 12 (26:11):
Didn't go thirty five days the last time, but it
went a couple of weeks.
Speaker 2 (26:16):
And did they give you any medication.
Speaker 11 (26:19):
No, sir, they told me to take Oh what's the uh.
Speaker 12 (26:27):
Orange power did you take to help your ball mules?
Speaker 11 (26:32):
To take that every day? And I took that every day.
Speaker 2 (26:35):
Okay, So.
Speaker 12 (26:38):
But no, I did go through through all the UH
well it was a significant test, I think, the last
the lab workout and the UH the other procedures.
Speaker 11 (26:48):
So, but that was a year ago. I was in
March of twenty four.
Speaker 2 (26:53):
Yes, sir, yes, correct.
Speaker 1 (26:55):
So the thing about these diseases is that they don't
all present themselves in a very classic presentation, and sometimes
even though you did have an appropriate workup, we don't
find anything at that time. The idea, and I've mentioned
this before in the show, is you have to have
(27:18):
an open mind about getting reevaluated. And I think that's
what you need to do, is to get re evaluated.
And a lot of times we will run those same
tests just because sometimes it doesn't show up initially, but
with repeated episodes and with repeated testing, it will then
show up whatever it's causing it, and then you get
(27:39):
your diagnosis. For most people, yes, any acute medical physical problem,
you go to your healthcare provider, they run some tests,
you get diagnosed. It works out for most right fat
percentage of the time, maybe eighty nine percent of the time.
With any sort of encounter with a healthcare provider, you
(28:00):
get the right diagnoses, But there is a small percentage
of those encounters where we don't know what's wrong or
the testing is negative, and it's frustrating for the patient
as well as a physician. I mean, obviously we want
to be successful each time we do an evaluation for
an acute problem, but we just are not able to
(28:23):
do that every single encounter. So what I have advised
patients now that I've been a physician for over twenty.
Speaker 2 (28:30):
Years, you have to get reassessed, and.
Speaker 1 (28:33):
You can go to the same doctor because they know you,
they have all your information, and they're familiar with your case.
But most of the time, we repeat those labs, we
repeat that scope, we repeat the scan again to see
if we overlooked anything or maybe something wasn't showing up.
Speaker 2 (28:52):
That's what you have to do.
Speaker 12 (28:55):
Okay, there's since I sort of had an introduction to
this back in twenty twenty four after my colonoscopy and
the other labor all the lab work on the colonoscopy
working whatever goes with that I was essentially dormous then
for a year, and then it just rears its head again.
(29:17):
Is that Does that unusual for a condition?
Speaker 11 (29:21):
Not necessarily, No, I'm talking about.
Speaker 1 (29:23):
No, No, it is not. Sometimes these conditions are intermittent.
They come and go as a matter of fact, so
it's not unusual. Again, we try to drive best to
hit a home run on the first encounter, but unfortunately
we're not always able to do that, and you have
(29:45):
to just get reassessed and run those same examinations, and
a lot of times on the second or even.
Speaker 2 (29:51):
Third wave of evaluation it gets discovered.
Speaker 1 (29:55):
At least that's been my experience with these sort of
undinoicable medical issues, that these diseases sort of become more advanced,
and the more advanced they get, it gets easier to diagnosed,
in my honest opinion, just because you get more physical
symptoms and the clinician is able to see the evidence
(30:17):
that they need to make a diagnosis, just because sometimes
initially it's unclear. It's a lot of things that can
cause diarrhea, and there's a process of elimination they go
through to try and figure out which one it is.
So with each evaluation they get better and closer and
more precise about what it is or it's not. But
(30:40):
you have to have the stamina to say to yourself, Okay, I'm.
Speaker 2 (30:45):
Going to go in.
Speaker 1 (30:46):
I know it's going to be time consuming, it's still cumbersome,
but I want to get to the bottom of it.
So you just have to dig in and allow the
clinician to go through their process elimination, maybe try some
different medications to get things under control. We normally, in
my experience, can get diarrheal illnesses controlled and diagnosed to
(31:07):
the point where it's not bothering you all day.
Speaker 2 (31:10):
We rule out a.
Speaker 1 (31:12):
Lot of significant pathology, you know, significant things like pink
ratic cancer, colon cancer, significant bowel inflammation like Crohn's disease.
These are some things that can cause diarrhea. So we
get a lot of that heavy hitter stuff out of
the way. And sometimes, yes we're at the end of
(31:32):
the day, we don't know, but we can get you
on a medication that might slow that down, and that
might be the goal for right now, just to kind
of get control over your bowel function. So but I think, yeah,
you need to get reevaluated, no question.
Speaker 12 (31:49):
I'll go in early next week. And ask for them,
tell them the science signed me up again.
Speaker 1 (31:56):
Yeah, and hey, Nick, give us a callback and let
us know what happened and what they came up with this.
Speaker 12 (32:05):
Have you ever heard or had a patient that has
had the chronicreer?
Speaker 1 (32:10):
Oh? Yeah, absolutely, it's very common. It's very common, very common. Yes, absolutely,
So we see it often. It's frustrating, but like I said,
normally we can get it calm down. There are several
medications that you can take daily that can keep the
volume of stool to a controllable amount so that you're
(32:34):
not in the restroom all day long. You can go
to the restaurant, you can travel, you can go to work.
We can normally find something that can slow that down
so that it's not interfering with your lifestyle.
Speaker 2 (32:47):
So but yeah, I just got to get reevaluated. All right, Nick?
Speaker 14 (32:56):
All right?
Speaker 2 (32:56):
We appreciate Nick's call chronic diarrhea. Who wants that? Right?
Speaker 1 (33:00):
But we see it a lot of phone lines open
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Portions of the following program where we recorded This is
No on Ryan coming to you from the American Standard
are dot Com Studios with news Talk five sixty klv I.
You are listening to Doctor Levine's Medical Hour on news
Talk five sixty KLVII. To join the conversation, call eight
nine six klv I are eight hundred three three zero
(36:30):
klv I.
Speaker 1 (36:41):
All right, Welcome back to the Doctor Dmclour phone lines
are open eight nine six kV I one one hundred
three three zero kov I talking about various talks, including diarrhea.
Last call on that we all have a periodically some
change in our bowel habits. One thing that Americans suffer
the most, in my opinion, is constipation. However, that's sort
(37:04):
of an opposite experience. You're going several days without eliminating,
and that is a huge problem in our country, primarily
just because of our lifestyle choices.
Speaker 2 (37:19):
To big reasons for that.
Speaker 1 (37:20):
Inactivity breeds a slowing down of your bowel activity, as
well as the types of foods that we eat, and unfortunately,
most of us are eating foods that do not contain
a lot of fiber, just because most of the time
we're eating processed foods, and processed foods tend to have
(37:43):
a low fiber presence, and so you're sort of eating
things that do not promote good and bowel health. And
then we're inactive. So that combination a lot of times
will generate constipation. And there's a whole host of medications
over the counter that help with constipation.
Speaker 2 (38:05):
A lot of them are very good, they're safe.
Speaker 1 (38:08):
The most popular over the counter is called mer Relax.
Mr Lax comes in a powder typically and you basically
pour it in whatever liquid that you're drinking, and you
have a couple of those mer relax maybe twice a day,
three times a day, once a day, every other day.
Speaker 2 (38:31):
It doesn't matter.
Speaker 1 (38:31):
Everybody's different, but basically it does introduce a increased frequency
of your bowel habit, so that you're eliminating maybe once
a day or every other day. Believe it or not,
some people go several days, four or five days without eliminating,
even though they're eating every single day. Remember, a body
is in balance, right. Homeostasis is the name for that,
(38:55):
and it's trying to achieve that every single day, so
that if you're eating every you should be eliminating every day,
just like you urinate every day, and if you don't,
that's a concern that normally generates i'm sorry, or indicates
an imbalance. Maybe something's wrong with your bladder, maybe something's
wrong with your kidneys.
Speaker 2 (39:15):
You should be.
Speaker 1 (39:16):
Alarmed if you go all day and you haven't had
any urination, especially if you are drinking every single day.
We sort of get into that during the summer months, right,
just because dehydration can generate some i'm sorry, exposure to
heat can generate some dehydration that can decrease your your
(39:37):
bowel flow, I'm sorry, your urine flow if you're not
drinking a lot. But certainly constipation would be the biggest issue,
and changing your diets certainly would help. You know, heating
more fiber. Again, vegetables has a lot of fiber in it.
Nuts and seeds that has good fiber. Whole grains has
(39:58):
good fiber like flag see quene, wab buckwheat, millet, barley oats.
You know that those have a lot of fiber content
in them, and you can eat those in various different ways.
But certainly if you're eating frozen food or prepackaged food,
or you're eating at the fast food restaurants, a lot
(40:19):
of times the fiber is not there. And so if
you're eating that every single day, and then maybe work
at a job where you're not moving around as much
and you're sedentary throughout the day, then that can also
generate its own inactivity and just some of that combination
will cause that constipation issue. But there's the medication relax
(40:43):
is there available for you over the counter. You don't
even have to get a prescription, but there's several prescription
medications that we write for that work really well. Also
that doctors have and they're typically benign, they're not very toxic,
and you can take these medications lifelong. Anybody who's ever
(41:05):
started exercising, that's one thing that they always say is
that normally their bow habits return back to normal pretty quickly.
If you've ever been hospitalized or sick and you know,
you start sitting more, you laying down in the bed more,
that's one thing that happens is your bowel function slows
down pretty drastically. So just again an imbalance with that.
(41:27):
But again we'll get into that diar real issue, and
it normally requires a bunch of lab work. We normally
will test the stool for various elements, whether or not
there's infection in it or certain components in it that
will trying to help us figure out why you're having
such loose stool. And then we look at We certainly
(41:47):
do a cat scan because we want to look at
the gas intestinal system, especially if it's generating all these
bowel habits, want to see if it looks abnormal, does
the lining of the intestine look inflamed, is there sort
of some obstruction, Is there something wrong with your painkers
because it's involved with your digestive system as well. And
(42:10):
again just to look around and see if we can
find anything abnormal. And then the GI doctors will do
their scopes again just to look inside and see if
there's something there that might be mysterious and help us
figure that out. But always be open minded to get
reassessed no matter what physical complaint that you have. If
you were given some prescription medications and you got your
(42:33):
discharge paperwork and they gave your diagnosis, everything sort of
makes sense. But three days later you don't feel good,
you feel worse, maybe the symptoms are not improving.
Speaker 2 (42:43):
Got to go back in.
Speaker 1 (42:44):
You know, even to the same practitioner, different practitioner, and
sort of get another evaluation. A lot of times the
same tests will be repeated, just because sometimes it's not
clear initially, but on follow up it's very obvious what's happening.
And then the medication get cary a changed, and then
you get the right diagnosis and then you get better.
(43:06):
But you have to keep an open mind about that
when it comes to that. Phone lines are open eight
nine to six Scalvy I won one hundred three to
three zero.
Speaker 2 (43:14):
Kalev I would go in our last break for.
Speaker 16 (43:16):
Sam Altman, the creator of jat GPT and it's parent company,
open Ai. Last week was a total watershed. Alman went
on record to say that he now believes artificial intelligence
has surpassed human intelligence. Perhaps in a very simplistic view,
he might be right, but the sum of human intelligence
and life itself is not so simplistic, and that makes
(43:36):
Sam Altman dead wrong.
Speaker 2 (43:38):
I'm Kim commander for Oracle.
Speaker 16 (43:40):
In business, you can have better, cheaper and faster with
Oracle cloud infrastructure. Try oci for free at Oracle dot
com slash Kim. In his blog, Sam Altman says we
are past the event horizon that a takeoff has started,
but Alman fails to see what we call intelligence. It's
a great deal more than just a collection of facts
and figures. Perhaps on that level only a I may
(44:00):
have the edge, but real intelligence is judgment and emotional control.
It's the experience of the experience. Human beings invented artificial intelligence.
AI cannot invent a human. Sign up for my free
newsletter right now at getkim dot com. In business, they
say you can have better.
Speaker 17 (44:18):
Cheaper or faster, but you only get to pick two,
But what if you could have all three at the
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(44:40):
workload in a high availability, consistently high performance environment and
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Speaker 16 (44:46):
So how is it faster? OCI's block storage gives you
more operations per second cheaper. OCI costs up to fifty
percent less for computing, seventy percent less for storage, and
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OCI customers report lower latency and hire bandwidth versus other clouds.
This is the cloud built for AI and all your
(45:07):
biggest workloads. Right now with zero commitment. Try OCI for free.
Head to Oracle dot com slash kim. That's Oracle dot
com slash kim.
Speaker 3 (45:16):
You're listening to Doctor Levine's Medical Hour on news Talk
five sixty KLVII. To join the conversation, call eight nine
six klv I. Are eight hundred three three zero klv I.
Speaker 2 (45:41):
All right, welcome back to talk with the own line.
Leonard from GUS and I can we help you real quick?
Speaker 5 (45:48):
I'm calling texture with my diabetes. Sometimes when I'm driving
or sitting watching TV, it's feels like it's probably sticking
me in the foot with us eyespeak or something. What
do I do about that?
Speaker 1 (46:00):
Well, you know, litter as you know, you've had diabetes
for some time, and one of the issues that comes
up with diabetes sometimes is neuropathy or nerve injury, and
one of the symptoms of that is sort of a
numbness or tingling of the feet, and it can be
kind of painful. So most of the time that is
(46:21):
the cause of that, and you know, there's medications that
can be prescribed to you, but certainly foot care and
foot hygiene is very important for diabetic patients. As you
can get circulatory problems, you can get ulcers on the
foot that can then generate pain. You can get infections
(46:43):
such as osteomolitis that's infection of the bone.
Speaker 2 (46:47):
So a lot of.
Speaker 1 (46:47):
Times for diabetics, we advise that they examine their feet
on a regular basis, they see a pediatrist on a
regular basis just to get a good exam. But certainly
if you're having pain, are some discomfort of your foot,
then you have diabetes. Certainly, you know, look at it
yourself and see if you can see anything. But if
you can't, you might need some X rays such as
(47:10):
a plain X ray, you might need some studies on
your circulation.
Speaker 2 (47:15):
And yeah, to go buy and see the pediatris.
Speaker 1 (47:18):
Let them do an examination, make sure everything is intact,
make sure you don't have needles or foreign bodies stuck
in your skin of your foot. We see that all
the time with diabetics who have neuropathy. They come into
the er or the office and there's a big needle
sticking in their foot and that's been there for maybe
two weeks and it's infected. So yeah, if really, if
(47:42):
you have pain and discomfort and it doesn't go away,
just need to get checked out and make sure nothing
is going wrong.
Speaker 5 (47:49):
Okay, well I have a foot doctor, I'll go seeing.
But it's been I've had it for years, so it's
not a it's not a short term thing.
Speaker 1 (47:59):
Yeah, So probably it's something that's you've had and nothing
to worry about and probably related to a little neuropathy
there in your foot, just because the years of the
diabetes and you know nothing to worry about, especially if
you've already had it checked out and maybe you're on
some medication. But every now and then it might spike
(48:20):
for unknown reasons. That's just the way neuropathy is. But yeah,
if it's new, you certainly get it checked out. But
if it's old, maybe you can just get by and
reassure yourself.
Speaker 2 (48:31):
Just look at your foot and make sure it's okay.
Speaker 5 (48:34):
Is there an exercise or stretching things that I should do.
Speaker 2 (48:40):
For that particular problem.
Speaker 1 (48:42):
I'm unaware of any sort of physical therapy or stretching
that you can do to alleviate that, No, sir. Sometimes
you can get what they call a plantar fasciiis, which
is like an inflammatory condition of the tendon of the
bottom of the foot, and there are physical therapy exercise
that can do the involve stretching to help with that.
(49:05):
That can certainly generate pain in your foot. So that's
the reason to go to the paediats. Let them do
a reassessment and see if it's your neueropathy or if
it's something new. They have exercises for that, But just
for plano neuopathy, I don't know if any exercises that
can be done though.
Speaker 5 (49:22):
Sir okay, well thanks for guy all right learning.
Speaker 1 (49:26):
We appreciate that comment, and yes, if you do have
dabites type one or type two, we certainly recommend some
foot hygiene and we want you to examine your feet
at once a day or maybe once a week, and
certainly go by the pedotris maybe once a year.
Speaker 2 (49:43):
Let them take a look at everything.
Speaker 1 (49:45):
And the idea is that if you can't control the
sugar in your bloodstream, it normally doesn't cause any problems
with your feed but certainly if you start developing that,
go in and get that checked out, as it can
escalate to some pretty serious issues abscesses and infections, sometimes
unfortunately amputations of toes or the foot itself or the
(50:08):
little extremity. So the stuff can get pretty intense. But
it all falls back on knowing your numbers and keeping
the sugar, cholesterol and blood pressure down and that starts
with that lifestyle, right, eating the healthy diet and staying
away from the sugar. Anyway, we appreciate all of the
listeners and the phone callers. Don't drink and drive happy
(50:28):
father say that all the father's out there.
Speaker 2 (50:30):
We'll see you guys next week.
Speaker 14 (50:31):
Take care.
Speaker 4 (51:13):
Number one on your car radio precent, and then you
would improved iHeartRadio app.
Speaker 3 (51:18):
This is used Heart five sixty klv I Beaumont Free.
Speaker 2 (51:22):
Never sounded so good.
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