November 25, 2025 • 46 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
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
All right, welcome in and not radio listeners Southeast Texas. Welcome, Welcome, welcome,
and good morning, Good Saturday morning. This is your host,
Doctor Levine. I'm here live at the students of KELP.
I hear both my Texas Cross Street from Parking the
Mall every Saturday most of the time unless I'm out
for various reasons. I was out last week, so hopefully
(00:21):
had a good week last week and you enjoyed the
recorded show. We have some good ones out there, some
shows that I really enjoy. Sometimes I do listen to
my own show just to sort of get some pointers
about how to organize the show, maybe some topics. Remember,
if there's a topic that you would like me to
(00:42):
talk about, just give us a call or call my
office and you know we'll get into it. But hey,
the genesis of the show is to try and help
you figure out what do you need to do to
stay alive and answer those questions and just try to
simplify things because it is very complicated out there and
(01:02):
we're just not quite sure what is the right thing
to do. So we sort of need an independent voice
to help us with that. And I know there's a
lot more information flowing out there as it pertains to
your health and what to do. I remember when I
was just starting out as a doctor, the amount of
(01:23):
information handing to patients was minimal. Right when you went
into your doctor's visit, when you were discharged from the
er the hospital, you really didn't get a lot of paperwork.
I don't know if everyone remembers that, but now you do. Right,
(01:44):
you need a binder to hold all the paper that
you get, all the information you're being handed when you
interact with the healthcare provider of just about any level
here in this country. Because most healthcare providers healthcare institutions
have some sort of computer system that's just spitting out
(02:07):
all this information. It's it's overwhelming, to be honest with you.
I see some of these information packets that patients get
when they go to the minorcare, or they go to
Houston and they go to one of the bigger hospitals there,
and even here locally, they're just getting ten fifteen pages
(02:30):
of all sorts of paperwork, and it's kind of overwhelming
to when you look at it, especially if you don't
do it every day. All these numbers and red letters,
dark letters, terminology. I mean, when you're sick and you're
vomiting and you're weak, you don't feel like studying, which
(02:52):
is what that is, right, But honestly, it's a way
to communicate with you what is going on with you
so that you can be engaged and involved and certainly
record chronicle your disease process in terms of what the
(03:15):
doctors are doing and what they're diagnosing you with. As
you know, diagnoses are normally a very solid attempt to
name what it is it's happening to you. And as
if you listen to my show, you know that whoever
(03:36):
you are, wherever you go, Beaumont, Houston, Austin, Dallas, and
you interact with a healthcare provider, whoever that is, and
whatever setting that is, you know your diagnosis might change.
And I know that in talking with patients in my
office in the hospital that you are. That's frustrating for
(04:01):
the patient because you know they feel like, Okay, this
is what I have, and so I can focus on this,
and I can go to my internet on my website
site and I can read about it and okay, this
is what I have. Okay, done with, We're ready to go.
And then a second provider comes in maybe an hour later,
(04:22):
two hours later, same information, right, and they give you
a different diagnosis. God, I know that's super, super irritating,
and you know, I wish that we could be more
consistent when it comes to that. I think there are
(04:44):
certain situations that come up where everybody agrees, right, very easy, straightforward,
and everyone agrees, But so much of what I do
as a medicine doctor, and I'm sure surgeons have similar
cases that come up that are not so clear. Yes,
(05:05):
we're going to do surgery. No, we're not going to
do surgery. If we do surger, we're going to do
it this way. No, we're going to do it another way.
You know, just because medical training does not prepare you
for all the million trillion scenarios that can come up
in a day, in an hour with patients, and that
(05:26):
all boils down to your experience in handling these scenarios.
You know, if you haven't handled before, it's it's very
uncomfortable and you might not know what the best thing
to do because it's not something you faced before. So
obviously you're going to use your current knowledge and your
current expertise to try and figure out what is the
(05:48):
best solution for this particular day. Same thing with diagnosing someone.
Most of our diagnoses are our capabilities. Yeah, we can
pretty much hit the right diagnosis high percentage of time.
I would say ninety ninety five percent. We can boom.
We make the documents as we have this information, and
(06:09):
we talk to the patient, examine the patient. We kind
of know what we're dealing with and we go with it.
But sometimes the course does not play out the way
we wanted to. Whether you're in the office, whether you're
at the hospital, things don't go as planned and other
(06:30):
things start happening, our new physical symptoms start happening. We
have to shift gears and change our impression about what
it is that we think you have or don't have.
That happens every single day, and I know it's super
frustrating and it frustrates us as well. We would love
to have a crystal ball and tell you exactly what
you have and predict exactly what's going to happen to
(06:52):
you in three four days, two weeks from now, a
month from now. It's just we don't have that capability.
So certainly we're trying to share all of this information
with you so that you can have it at your
disposal at home two weeks from now, share it with
your family, talk about it, discuss it. That's really the
(07:16):
whole idea behind that. Just again, when I came out
average interaction with the patient at the end of it,
you might you might hand them some what we call
paper prescriptions, those little prescription pieces of paper that used
to get and you would take that to the pharmacy
(07:39):
and get your medications. But all of that knowledge, all
of those recommendations about well, we want you to stop
this and increase that, and then do this one every
other day, and then if this happens, and do that.
You know, all of that conversation that went unchronicled a
(08:02):
lot of times. Maybe the doctor wrote it in their
note or healthcare profession wrote it in their note, but
it's hard to remember all that when you're sitting there
talking with your health care provider. Again, you're in pain,
you have all your other duties in terms of if
you're a mother or a father, or you've got to
go to work, or there's just all of this popping
(08:25):
around in your head. And then here your doctor lays out,
you know, five instructions for you, and you're supposed to
remember them without any documentation whatsoever. That's the way we
used to do things. We would just tell you we
want you to do this, and here's a couple of prescriptions.
You know you need to take that to the pharmacy
and get that medicine refilled. Well, doctor, what is my
(08:49):
actual diagnosis? You know, we might tell you, but then
you would forget it. Hey David from Deer Park, what's
going on?
Speaker 2 (09:00):
Yes, sir, I had a question about poison ivy. What's
the best thing you can do for it? The best
thing I've been doing for it is putting that cortisone
ten on it. Is there anything better for that?
Speaker 1 (09:14):
Poison ivy is sort of an allergic skin reaction to
a certain chemical and the poison ivy plant. I'm sure
there's a more technical name for poison ivy plant. I'm
not that type of scientist, but there's a chemical in
that plant that when some patient's skin gets in contact
(09:37):
with it, it sets off an allergic reaction. So you
get significant itchiness, redness, and it can spread pretty easily.
So anytime there's sort of an allergic component to the rash,
we normally start off with antihistamines, which is you know
what benadryl is and we also do steroids. Steroids are
(10:02):
a anti allergy, anti inflammation medication as well. So steroid
creams like hydro cortisone work pretty well. They have the
over the counter version. Then they have some prescriptions as well.
If so David, normally I go to CPS, Walmart wherever
(10:23):
and get you some benadryl, gets you some hydrocordizone cream,
and you could start with that, and if the area
is small and it's not diffuse, that might be enough
and that's all you need and you just can go
on without ever seeing any healthcare professional. But if it
is more severe or it keeps spreading, then normally we
(10:47):
have to do tablet steroids or more systemic steroids. You
can get an IV or you can get an injection
so that the steroid presence is just about everywhere and
it can sort of quiet down inflammatory system. And then
we can also give you a prescription strength topical steroid
(11:08):
which is normally stronger and has more effectiveness with churning
off the allergy inflammatory reaction of the skin as it
pertains to this chemical. Most people don't really come in
for poison ont because they just run to the pharmacy
and everything's happy, but every now and then some bidy
(11:29):
will come in. It's just all over and it's severe
and we have to do, like I said, the injections
or the tablet steroids to get it knocked out. That
answer your question, David.
Speaker 2 (11:42):
Yes, Trudeaus, I appreciate it all.
Speaker 1 (11:44):
Right, buddy, appreciate the phone call. Yeah, don't forget that.
A lot of the medications that are now over the
counter at we're at one time prescription, meaning you had
to go to your doctor get permission to take it. Right,
(12:08):
That's what a prescription is, right, a permission. You got
your permission slip to take this medication that might harm you.
You need a medical person to review your case and
sign off on this particular product for you to take it,
(12:29):
because it needs as someone who's studied these drugs and
studied you, and we want to make sure that this
is safe and that you need it, and we want
to try and control the amounts that you get. So
go get your permission slip from the doctor. But a
(12:52):
lot of times, after a certain period of time, I
think it's five years, maybe ten years, a lot of
these prescription drugs are now over the counter or OTC
and you can go pick them up at your earliest
convenience without having to sit at doctor Levine's office for
three hours waiting to talk to him. Audrey from Vaider,
(13:16):
how you doing, Yes.
Speaker 3 (13:18):
Good morning. About a few weeks ago, I developed some
sore and redness and it was inflamed on the back
of my leg. So I went to one of the
local clinics and she diagnosed it as cellulitis. But the
(13:42):
strange thing about it was about a year ago I
had skin cancer taken off on the back of my
leg and that was the very same place where this
cellular light is developed. The scar was maybe about three
(14:04):
or four inches long, and I just found that kind
of weird that that's where it would develop. What do
you think about that?
Speaker 1 (14:14):
It is an unusual location for that particular condition. But
skin cancerlitis honestly can develop anywhere.
Speaker 3 (14:24):
I mean it can.
Speaker 1 (14:26):
The human body is very weird, unpredictable.
Speaker 3 (14:30):
Yeah, And it.
Speaker 1 (14:31):
Just takes a good physician or healthcare professional and have
a high index of suspicion as it pertains to cancer
or slitis to make that diagnosis. As I was talking.
Speaker 3 (14:44):
To the doctor, gave me around to the antibiotics in
about a week. It you know, the inflammation and the
soreness was gone.
Speaker 1 (14:55):
Well good, that's awesome that the system worked.
Speaker 3 (15:00):
Is Can I ask you one more question? Why do
they require a low fat diet for a PET scan?
Speaker 1 (15:16):
Low fat diet for PET scan? I'm not a radiologist,
and a PET scan is a specialized X ray test
that primarily is used in the cancer world to initially
help make a diagnosis of cancer as well as to
(15:38):
follow cancer.
Speaker 3 (15:41):
Doctor. I'm sorry, I'm in a low carb.
Speaker 1 (15:45):
A low carb diet.
Speaker 3 (15:47):
At ye, a low carb diet. I'm sorry, I got
the two make sed out.
Speaker 1 (15:52):
Well, that's okay. The as far as I know, my
basic basic understanding of PET scans is that it's it
is all built on the activity of the particular cell
that you're thinking of, whether it be a lung cell
or brain cell. And most yeah, most human cells operate
(16:17):
on sugar, right, They need sugar to operate, and the
PET scan is the way they do this scan is
they basically put some sugar in your bloodstream and they
see whether sugar goes. And the idea is that anything
that is needing a lot of energy, like cancer that
(16:44):
normally consumes a lot of sugar, consumes a lot of energy.
That sugar will go to that cell, and they sort
of attach a radioactive chemical to it, and so they
just sort of follow the sugar basically and take a
picture of your body and they see where all the
(17:04):
sugar is going. I'm assuming it has to do with
something like that. They don't want to they don't want
you to eat all this sugar and then they inject
you with sugar and it might complicate the results of
the test. I'm assuming it's going to be something like that.
It's a very crude explanation, but I'm assuming it has
(17:26):
to do with something like that. How many days prior
to the test that they tell you to eat a sugar.
Speaker 3 (17:33):
Diet the day before and the following morning it was
all okay.
Speaker 1 (17:42):
Like I said, I'm not a radiologist. I don't know
the fine details of that, but I do know that
PET scans is all about testing the activity of the cells.
And again, when there's hyperactivity or high activity of the cell,
it tends to consume more sugar in the bloodstream, and
(18:04):
so sugar then will go to that cell, and so
they will attach radioactive compounds to the sugar that they
inject and I see where it goes. And then they
take a picture of the body and depending on the
amount that's in the cell, they can say, ah, that's hyperactive,
(18:25):
and ah it's lighting up, and yes, more than likely
it is cancer because the amount of sugar that it
consumed and this amount of time is more consistent with
this versus that.
Speaker 3 (18:39):
So a PET scan is more detailed than a CAT scan.
Speaker 1 (18:46):
No, it's just two different X ray modalities and they're
looking at different things. The PET scan, like I say,
in my opinion, is more of a functional activity scan,
whereas a CAT is just a picture of the anatomy.
That's all. The CAT scan does same thing with an MRI.
(19:07):
It just takes a picture of the anatomy, that's all
it does, whereas a PET scan is more of a
picture of the activity of the human body. Like the
body is a machine and the PET scan is able
to look at the activity of the machine and see
(19:28):
if there's some particular area that's more active than others.
Because cancer is a very hyper cell, it's more hyper
than it needs to be because your brain, sell, your
hard sell, your liver cell is supposed to operate within
a certain boundary under control basically, and when that control
(19:52):
or when the control is lost and the cell is
hyper that's more consistent with cancer, because that's really what
cancer is. It's just hyperactivity of a cell. And normally
when it's hyper it it does not function very well.
It normally tends to spew out other toxic hormones and
toxic chemicals and that will then circulate through the human body,
(20:16):
which is why a lot of times if you have cancer,
you lose weight, you don't have a good appetite, you
don't feel good, just because the cancer is spewing out
all these toxic hormones in your bloodstream. As it is
very hyper and its activity, it's out of control, if
you will. So the PET scan can test sort of
(20:37):
that hyperactivity, whereas a cat scan and the MRI and
ultrasound they're just taking pictures of the particular part of
the human body. So you said lung, So most of
the time you would get a cat scan of the
lung and it's just a picture. It does not test
if it's functioning or not. Just it just it's a picture,
(20:59):
that's all it is.
Speaker 3 (21:01):
Okay, thank you, hopefully.
Speaker 1 (21:05):
Hopefully helps you out. And I didn't confuse you more.
Speaker 3 (21:08):
Oh no, that was good.
Speaker 1 (21:11):
Thank you all right, Audrey, I appreciate it. Doctors don't
know everything. I have to read just like everybody else
and keep up with it, which is why I loved
my career and I love my profession. I like reading.
I grew up reading a lot when I was in elementary.
I went to Blanchet Elementary here in Beaumont, Texas, and
(21:34):
we used to have the Riff program. I don't know
if you guys remember that. Riff Reading us fun and
like three or four times out of the year we
would go to the cafeteria and they would just have
all these books sitting there and we could get two books, anyone,
(21:54):
any two books you wanted. And uh, I don't know
what happened to that program. I don't know if it's
still around. Riff reading is fun, But anyway, I learned
to enjoy reading, and I do love reading. I don't
have a lot of time to read now because I'm busy.
I interact with a lot of my listeners out there.
(22:16):
I see them in the hospital, see them in the office,
and yeah, it's it's hard to get all that in
when you're you're doing other things. But yeah, go pick
up a book to Dan read anyway. Phone lines open
eight nine six KLV one hundred three three zero ko
if I'll be back in two minutes. All right, welcome
(22:49):
back to the dark Lavine Medical. Our phone lines are
open eight nine to six kV I one one hundred
three three zero kov I sitting here talking about poisoning
as well as pet scans, cat scans and reading. Yes,
reading is fun, riff. It's a great program. We need
to look up and see if that program is still around.
(23:12):
And a lot of people always ask like, well, how
much reading do doctors actually do once you get out?
I mean, we all know that medical education is long
and it's arduous, and you have to spend a lot
of time in the hospital and just reading and studying.
And I think most people get that. But once you
(23:32):
get out, you have your degree, you have your license,
you're out practicing. How much do you guys really have
to read? And it's sort of all over the place.
But there is what they call continuing medical education or
CME for short, and to have your license and to
(23:52):
be allowed to a lot of times work at hospitals
or certain medical facilities, they were require you to have
so many hours of cm E every year or every
two years, whether it be I think we up to
twenty five hours, maybe fifty hours. I think it's maybe
twenty eight hours a year, and so you have to
(24:16):
engage in some sort of what we call CME program
continuing medical education program that equals twenty six twenty eight hours,
which man and the way to do that is highly variable.
When I came out, a typical way of doing that
(24:38):
is to go to a conference, like a weekend conference,
and you'd get there Friday and you would spend maybe
you get there Thursday, and you would spend Friday, Saturday,
maybe Sunday in a lecture hall listening to various lectures
about various topics, and that was your continuing medical education.
(25:04):
You normally had to take off from work, you had
to travel, spend time away from the family. It was
sort of a big commitment, and that was the way
a lot of that was done. Now with phones and
the information how it spreads now, it's much easier. Most
doctors don't have to do that anymore. You can complete
(25:26):
CMME just sitting there in your office on your phone.
You can do it that way. They still had their conferences.
But again that's a lot of time, it's it costs,
and if you can just do it very easily with
your phone at your house, I mean, I mean, it
doesn't even compare. That's just one way to do it.
(25:49):
So doctors do have to keep up with sort of
what's going on out there, but they don't really tell
us what area of medicine to keep up with. I mean,
it's really up to us what we want to do
in terms of how we want to spend those hours.
They don't really dictate to us. You have to do this,
you have to do that, at least not yet. So
(26:11):
again that's sort of why you get different sort of
decision making and a different approach to a certain disease
process or certain medications. You might go to doctor Levine
over here, and then you don't like doctor Leavine and
go across the street and you get some other doctor
and they do it different. That's a lot of times
(26:32):
why you get that, or they dicnise you with this,
then you go to another person and dicnoise you with
something else. It has so much to do again with
what that practitioner has seen on a regular basis and
certainly their knowledge level, and it's just going to be
highly variable. There's really no mechanism in place for you
(26:52):
to know exactly what the knowledge of your practitioner is
when you see him. I mean, yeah, you can go
on line and look at the reviews and all that,
and there's a lot of controversy with these online reviews
whether or not it's real or it truly represents the practitioner,
and that that's a tough one as well. But there's
(27:13):
no mechanism in place to actually know what your practitioner's
knowledge base is, what their experience is when you see them.
Maybe in the future we'll have that, but we don't
have that now. And it's not that anybody's trying to
do anything wrong, it's just that the system is not
set up are geared yet to make every doctor the same.
(27:35):
I think they're trying to get to that point by
introducing some regularity in what each physician knows. You know,
if you're a surgeon, you're a medicine doctor, no matter
where you go in this country, you should sort of
be getting the similar sort of diagnoses and the similar experience.
(27:56):
They're trying to get that get it to that point.
It's hard dealing with human beings and a lot of
different attitudes. And each system is different, meaning that the
system at doct Levine's office is different from the system
at the major hospitals. The computers are different, and the
staffing is different, the culture is different, and all of
(28:18):
that sort of impacts what your experience is going to
be at a particular institution. And again, they're trying their
hardest every day to kind of make it the same.
Just like with when you go to a burger place,
right and it's a certain burger company, You're getting the
(28:39):
same experience at this particular company or burger business that
you get no matter where you go. You travel out
of town, you see those you see that sign, Aha,
I know what I'm going to get when I walk in.
So you walk in and you get that experience. They're
really trying to do that with medicine, and I don't
(29:00):
have a problem with it because a lot of medicine
is routine and we're seeing the same diagnosities. It's the
same medicines, it's the same X rays, whether it be
a PET scan or a CT scan, And I think
it does improve outcomes. It does introduce a sort of
a systemic approach in how to handle and manacings. If
(29:23):
you've ever had chest pain or heart attack, you know
there's a system in place called cardiac alert that has
been developed over the years so that when a button's
pushed that certain things fall into place automatically to get
this particular person seen in a systemic way. They're doing
(29:43):
that with strokes. Now sepsis. You've heard of sepsis? Right,
you listen to my show. You're Smart? Hey, Leonard from Houston?
What's going on?
Speaker 4 (29:55):
A couple of months ago, I spent two weeks in
the hospital. Since getting out, I had a real follow
with shortness of breath. I've been prescribed iron pills. I've
been eating the liver like I was told to do.
I ride the stationary bicycle. It doesn't seem to do
any It does seem to do some good, but it's
(30:16):
not fast enough. What more can I be doing to
get my strength back?
Speaker 5 (30:24):
Well?
Speaker 1 (30:24):
I guess one thing I want to make sure is
that your system is still working and that nothing has
happened since you left the hospital. So most of the
time we want you to see your healthcare provider within
a week of getting out of the hospital or rehab.
Let them listen to your lungs and your heart, do
(30:45):
a physical examination, and if necessary, do hsst X ray,
do labs to make sure that all looks okay, because
you could have developed a lung infection, you could be
more you could have an EMI, you could have a
hole in your chest, which we call a new mol thorer.
(31:05):
I mean, all these things can pop up just all
of a sudden, which can cause shortness breath, cause you
to feel bad, and you wouldn't know it unless you
went in and got checked out. But if all that
is fine, Leonard, Sometimes, yes, the ugly side of getting
older is that we just don't recover us fast. Just
(31:26):
it tastes longer, and I know it's super frustrating, but
we just don't bounce back as quickly as we did
when we were, you know, thirty years older, thirty years ago,
and it's just a more longer process of getting back
to your previous health, and unfortunately, sometimes you never ever
get back there for various reasons. Really, yes, well, so
(31:51):
that is.
Speaker 4 (31:51):
The hard doctor. I went to the hard doctor the
other day and he did whatever he did, and you're fine,
and come see me in three months. Yeah, I think Yeah,
to be good news.
Speaker 1 (32:01):
Absolutely, But I think you need to be patient and
just understand that the body just does not recover as
well as you get older. That is the essence of aging,
it really is. We don't repair ourselves as well, we
don't tolerate stress as well. We're weaker, and god, you know,
(32:24):
hopefully if you do have to be hospitalized, whatever is
happening to you can be fixed and you can get
out as soon as possible. Because the long as you
stay in the hospital, I mean, the weaker you're going
to get, the long it's going to take you to
get back on your feet. That's just what I've seen.
But it sounds like you're recovering in as good a
(32:45):
fashion as possible. Just you'd need a little bit more time,
all right.
Speaker 4 (32:49):
Well, if it's just if that's the answer, that's the answer,
that's a good guy, Okay.
Speaker 1 (32:54):
Buddy Lennon. We appreciate that. And I work in the
hospital every day and I talk to families every day,
patients every day about this exact issue of how the
human body reacts to a medical trauma or a medical stress.
(33:16):
How you can go from cutting your grass outside, driving
your car, going to church, getting your groceries, living independently, right,
paying your bills, cleaning your house. Two weeks ago, you
do all that, and then now all of a sudden,
you're in the ICU. You're fighting for your life and
(33:41):
you might not recover. I see that every day, and
it has to do with the aging process. It is
real and you need to respect it if you are
getting older, because it is a programmed aging issue. Your
(34:01):
body is programmed to do that. So your immune system
doesn't work as well, your blood vessels don't work as well,
your heart doesn't work as well. And when you get
medical stress and you need strength, you need endurance, well,
that aging process is they're putting a brake on all that.
(34:23):
That's why that happens, where you can go from two
days ago to now you're fighting for your life and
you might not recover, just because the severity of stress
is too severe. The body cannot tolerate it. See that
every day. That's why we talk about those vaccines. Phone
lines are open eight nine six Scalvy I one hundred
(34:45):
three three zero, Okayalvy, I'll be back in two minutes.
All right, welcome back to the dark Lavinion Medical. Our
phone lines are open eight nine to six Scalvy I
one one hundred three three zero kyo. Yeah, we have
a Michael from how can we help you?
Speaker 5 (35:02):
Good morning, doctor Levine. Yes, sir, I have ah my
middle toe on my left foot. Uh, I've been having
trouble with it. It's it looks like it's a callous.
I went and saw a skin doctor and he told
me that. I asked him, was reward or something? He said, no,
(35:26):
it looked like a callous. And he suggested that I
put a a tab on that he had and I've
been doing that, but it's not helping. Uh, and I'm
not sure if it's a calous or not. I had
a friend that had a similar problem. He went to
(35:46):
a foot doctor, and a foot doctor cut it out.
And but he's in another state and not particular doctor,
and what well, what do you know about callous is
on toes. It's on the tip like the pad portion
(36:11):
kind of a kind of sideways in my centered. I
actually cut it, cut it off about it six months ago,
and I was wearing a bandage on it and it's
seemed to go away. Finally i'd stopped with a bandage
(36:32):
and uh, it had healed up good. From where I
had cut cut it off. Uh, so I'm not sure
what I got. I don't know if I have a
callus or what. And so my question is is if
it is a calus, how do I get what? What
(36:53):
do you do for a callous? It's gotten painful now.
When I was wearing a bandage on it. When I
say bandage, it was band aids, a couple of band aids,
and it didn't bother me when I hand the bandage on.
But now I don't have the band the agon, it
(37:13):
does bother me. So I'm going to get I need
to go somewhere and get it fixed. And what do
you think?
Speaker 1 (37:23):
Yeah, most of the time with callouses, it just represents
a area that is receiving a lot of pressure and
friction that the body or the skin system reacts to
to basically protect itself. So, certainly as we get older
because of arthritis and other muscular scalular problems, the way
(37:46):
we walk puts pressure on certain parts of the toes
and the body reacts to that by forming that callous
or protection if you will, is what a lot of
times a callous is so that it can not be injured.
So sometimes, yeah, the callus can get large enough that
it needs to be trimmed, and that's a lot of
(38:06):
times what foot doctors will do is just going there
and just kind of trim it up so that it's
not so big. They have multiple little things that you
can do over the counter. A lot of times, these
topical patches that you can put on the callus to
chemically dissolve the callous. You can do that, like these
wart remover band aids that you can get that will
(38:31):
sort of enzymatically debreed the callous. And then yeah, certainly
going to see a foot doctor just to get an
exam and see if there's any way that they can
help you take pressure off that particular part of your
foot that's having the callus. So a lot of times
there's shoe inserts or what they call orthotics that they
(38:53):
can provide for you that you put in your shoe
so that when you walk, it distributes the pressure better
so that this particular area that's forming the callous doesn't
have as much pressure on it. And if not, then
you know, the callous will go down or I won't
get continue to get bigger. And then like I said,
you might have some sort of anatomical problem that needs
(39:15):
surgical attention, maybe helping you with your footwear and helping
you get into some shoes that are better for your feet.
So certainly working one on one with the foot doctor
of podiatrist would be the best thing to do.
Speaker 5 (39:32):
That callous. Well, first of all, when I wore that band,
it didn't I didn't have as much noticeable pain. But so, well,
you give me a good answer. I just what I
(39:56):
was going to say is that I really don't put
pressure on that toe. I don't. I just don't understand it.
Just it just doesn't make sense, Oh that there were
callous on that poe of changed shoes, check shoes, and
so I hope it's only a callous.
Speaker 1 (40:16):
Yeah, And that's why it's good to work with pediatris.
These are foot doctors and they are familiar with callouses
and bumps and all the things that happened with the
toes and the feet. So that's why you have to
work one on one with them. Yes, sir, you don't.
Speaker 5 (40:33):
I know you're in Beaumont, but you don't have a
recommendation here for one day.
Speaker 1 (40:41):
Just get with your primary and they will know where
the pediatrist.
Speaker 5 (40:44):
Are Okay, thank you very much.
Speaker 1 (40:47):
You're always very informed to appreciated. Michael, have a good day.
And yeah, callouses on the toes and the feet, And again,
I guess we don't spend too much time talking about
the feet. Are the toes. We talk about shoulder pain,
back pain, knee pain, right, but yeah, you can take
(41:09):
a look at those feet. They start to bend in
all sorts of different ways, and your toes start looking
a little odd in terms of the orientation of your toes.
And some people have pretty bad muscle scale the problems
of their feet. Remember, you're walking every day, so it's
receiving a lot of pressure every single day. And again,
(41:32):
depending on your weight and your overall general health, you
might start getting a lot of issues with your feet.
I've seen some pretty bad feet over the years, and
especially we all know about type two diabetes or type
one diabetes and when it causes nerve injury to your
feet and how that can leave your foot vulnerable to
(41:54):
injury just because the nervous system when a normal foot,
protects the foot from end a lot of times. But
when you lose the sensation, then again, the bottom of
the foot, the top of the foot, the side will
start to get all sorts of friction and pressure points
that it's not designed to handle until it breaks down.
(42:15):
And that's why a lot of times you can get
these ulcers on the bottom of your feet. A lot
of times patients are diagnosed with diabetes just because they
get an ulcer in their foot. They don't know why
they have it, but you check the numbers and their
sugar is sky high and they can't necessarily feel the
bottom of their feet, and so that's how that starts.
(42:36):
That's probably the most common cause of just sort of
ulcer formation of the feet in our country. But again,
just the muscle scalar system gets older, and the way
we walk changes because of the changes of the knees
in the back and our muscle mass, and if we're
getting pain when we walk, I mean, all that stuff
(42:57):
changes our gate gai t and then that changes where
your foot hits the pavement and the way you walk.
All that so you can start getting some skin breakdown
or callous formation in certain parts of of your foot,
and it's just a reaction that your foot has again
(43:18):
to toughen up, if you will, which is why if
you start walking barefoot all the time, you'll get a
lot of callous formation on the bottom of your feet
and it's just a reaction and certain degree is nothing
wrong with it. Your foot are tough enough and before
you know you walking on bare feet all the time.
I mean, we don't recommend that because there's all sorts
(43:40):
of things on the pavement, sharp metal, sharp metal items
that can get embedded in your foore. We don't recommend that,
but again that's what would happen. And sometimes yes, it
gets too large and you have to kind of clean
it up, shave it up. They have all of these
ensomatic debreatment band aid appliances out there. You can go
(44:02):
to the pharmacy doctor Shoals I think has a big
product line where you kind of fit the band aid
to the size and location of the callus and get
that thing down. And then yeah, pay attention to some
of your shoes. Again, not all shoes are created equal,
(44:23):
some are better than others. And again depending on your
anatomy and normal. A lot of times if you do
go to Padaca's, they'll do X rays of the foot
just to look at the orientation of your bones and
see if they can kind of make things right with
these shoe insarts called orthotics, which a lot of times
they design personally for your foot and how you walk.
(44:47):
I think they have some special equipment in their office
so that you can get tested to design that. So
you would sort of basically put these things in your
shoe every day and make you walk better so that
these calusys dom for them. And hey, foot problems can
turn into major problems. I mean, have you in the
(45:08):
hospital for two weeks, four weeks, six weeks getting ivy
antibiotics the pain. So you've got to protect your feet, especially,
like I said, if you have diabetes, we want you
to examine your feet normally once a day, just look
at the bottom of the feet and if your diabetes
is not well controlled, then certainly get to a foot
(45:30):
doctor maybe once a year, have a good exam, and
never ever ever walk barefoot if you have diabetes. Is
because man, so many things can get stuck in the
skin and cause infection and abscess and the crosis. We
see it every day. It's amazing. Anyway, thank you for
joining the edition of the show. Remember don't drink and drive.
(45:52):
Eat some vegetables, I say, cucumbers, but hell, you can
have anything you want. We'll see you guys next week.
Take Care app
All right, welcome in and not radio listeners Southeast Texas. Welcome, Welcome, welcome,
and good morning, Good Saturday morning. This is your host,
Doctor Levine. I'm here live at the students of KELP.
I hear both my Texas Cross Street from Parking the
Mall every Saturday most of the time unless I'm out
for various reasons. I was out last week, so hopefully
(00:21):
had a good week last week and you enjoyed the
recorded show. We have some good ones out there, some
shows that I really enjoy. Sometimes I do listen to
my own show just to sort of get some pointers
about how to organize the show, maybe some topics. Remember,
if there's a topic that you would like me to
(00:42):
talk about, just give us a call or call my
office and you know we'll get into it. But hey,
the genesis of the show is to try and help
you figure out what do you need to do to
stay alive and answer those questions and just try to
simplify things because it is very complicated out there and
(01:02):
we're just not quite sure what is the right thing
to do. So we sort of need an independent voice
to help us with that. And I know there's a
lot more information flowing out there as it pertains to
your health and what to do. I remember when I
was just starting out as a doctor, the amount of
(01:23):
information handing to patients was minimal. Right when you went
into your doctor's visit, when you were discharged from the
er the hospital, you really didn't get a lot of paperwork.
I don't know if everyone remembers that, but now you do. Right,
(01:44):
you need a binder to hold all the paper that
you get, all the information you're being handed when you
interact with the healthcare provider of just about any level
here in this country. Because most healthcare providers healthcare institutions
have some sort of computer system that's just spitting out
(02:07):
all this information. It's it's overwhelming, to be honest with you.
I see some of these information packets that patients get
when they go to the minorcare, or they go to
Houston and they go to one of the bigger hospitals there,
and even here locally, they're just getting ten fifteen pages
(02:30):
of all sorts of paperwork, and it's kind of overwhelming
to when you look at it, especially if you don't
do it every day. All these numbers and red letters,
dark letters, terminology. I mean, when you're sick and you're
vomiting and you're weak, you don't feel like studying, which
(02:52):
is what that is, right, But honestly, it's a way
to communicate with you what is going on with you
so that you can be engaged and involved and certainly
record chronicle your disease process in terms of what the
(03:15):
doctors are doing and what they're diagnosing you with. As
you know, diagnoses are normally a very solid attempt to
name what it is it's happening to you. And as
if you listen to my show, you know that whoever
(03:36):
you are, wherever you go, Beaumont, Houston, Austin, Dallas, and
you interact with a healthcare provider, whoever that is, and
whatever setting that is, you know your diagnosis might change.
And I know that in talking with patients in my
office in the hospital that you are. That's frustrating for
(04:01):
the patient because you know they feel like, Okay, this
is what I have, and so I can focus on this,
and I can go to my internet on my website
site and I can read about it and okay, this
is what I have. Okay, done with, We're ready to go.
And then a second provider comes in maybe an hour later,
(04:22):
two hours later, same information, right, and they give you
a different diagnosis. God, I know that's super, super irritating,
and you know, I wish that we could be more
consistent when it comes to that. I think there are
(04:44):
certain situations that come up where everybody agrees, right, very easy, straightforward,
and everyone agrees, But so much of what I do
as a medicine doctor, and I'm sure surgeons have similar
cases that come up that are not so clear. Yes,
(05:05):
we're going to do surgery. No, we're not going to
do surgery. If we do surger, we're going to do
it this way. No, we're going to do it another way.
You know, just because medical training does not prepare you
for all the million trillion scenarios that can come up
in a day, in an hour with patients, and that
(05:26):
all boils down to your experience in handling these scenarios.
You know, if you haven't handled before, it's it's very
uncomfortable and you might not know what the best thing
to do because it's not something you faced before. So
obviously you're going to use your current knowledge and your
current expertise to try and figure out what is the
(05:48):
best solution for this particular day. Same thing with diagnosing someone.
Most of our diagnoses are our capabilities. Yeah, we can
pretty much hit the right diagnosis high percentage of time.
I would say ninety ninety five percent. We can boom.
We make the documents as we have this information, and
(06:09):
we talk to the patient, examine the patient. We kind
of know what we're dealing with and we go with it.
But sometimes the course does not play out the way
we wanted to. Whether you're in the office, whether you're
at the hospital, things don't go as planned and other
(06:30):
things start happening, our new physical symptoms start happening. We
have to shift gears and change our impression about what
it is that we think you have or don't have.
That happens every single day, and I know it's super
frustrating and it frustrates us as well. We would love
to have a crystal ball and tell you exactly what
you have and predict exactly what's going to happen to
(06:52):
you in three four days, two weeks from now, a
month from now. It's just we don't have that capability.
So certainly we're trying to share all of this information
with you so that you can have it at your
disposal at home two weeks from now, share it with
your family, talk about it, discuss it. That's really the
(07:16):
whole idea behind that. Just again, when I came out
average interaction with the patient at the end of it,
you might you might hand them some what we call
paper prescriptions, those little prescription pieces of paper that used
to get and you would take that to the pharmacy
(07:39):
and get your medications. But all of that knowledge, all
of those recommendations about well, we want you to stop
this and increase that, and then do this one every
other day, and then if this happens, and do that.
You know, all of that conversation that went unchronicled a
(08:02):
lot of times. Maybe the doctor wrote it in their
note or healthcare profession wrote it in their note, but
it's hard to remember all that when you're sitting there
talking with your health care provider. Again, you're in pain,
you have all your other duties in terms of if
you're a mother or a father, or you've got to
go to work, or there's just all of this popping
(08:25):
around in your head. And then here your doctor lays out,
you know, five instructions for you, and you're supposed to
remember them without any documentation whatsoever. That's the way we
used to do things. We would just tell you we
want you to do this, and here's a couple of prescriptions.
You know you need to take that to the pharmacy
and get that medicine refilled. Well, doctor, what is my
(08:49):
actual diagnosis? You know, we might tell you, but then
you would forget it. Hey David from Deer Park, what's
going on?
Speaker 2 (09:00):
Yes, sir, I had a question about poison ivy. What's
the best thing you can do for it? The best
thing I've been doing for it is putting that cortisone
ten on it. Is there anything better for that?
Speaker 1 (09:14):
Poison ivy is sort of an allergic skin reaction to
a certain chemical and the poison ivy plant. I'm sure
there's a more technical name for poison ivy plant. I'm
not that type of scientist, but there's a chemical in
that plant that when some patient's skin gets in contact
(09:37):
with it, it sets off an allergic reaction. So you
get significant itchiness, redness, and it can spread pretty easily.
So anytime there's sort of an allergic component to the rash,
we normally start off with antihistamines, which is you know
what benadryl is and we also do steroids. Steroids are
(10:02):
a anti allergy, anti inflammation medication as well. So steroid
creams like hydro cortisone work pretty well. They have the
over the counter version. Then they have some prescriptions as well.
If so David, normally I go to CPS, Walmart wherever
(10:23):
and get you some benadryl, gets you some hydrocordizone cream,
and you could start with that, and if the area
is small and it's not diffuse, that might be enough
and that's all you need and you just can go
on without ever seeing any healthcare professional. But if it
is more severe or it keeps spreading, then normally we
(10:47):
have to do tablet steroids or more systemic steroids. You
can get an IV or you can get an injection
so that the steroid presence is just about everywhere and
it can sort of quiet down inflammatory system. And then
we can also give you a prescription strength topical steroid
(11:08):
which is normally stronger and has more effectiveness with churning
off the allergy inflammatory reaction of the skin as it
pertains to this chemical. Most people don't really come in
for poison ont because they just run to the pharmacy
and everything's happy, but every now and then some bidy
(11:29):
will come in. It's just all over and it's severe
and we have to do, like I said, the injections
or the tablet steroids to get it knocked out. That
answer your question, David.
Speaker 2 (11:42):
Yes, Trudeaus, I appreciate it all.
Speaker 1 (11:44):
Right, buddy, appreciate the phone call. Yeah, don't forget that.
A lot of the medications that are now over the
counter at we're at one time prescription, meaning you had
to go to your doctor get permission to take it. Right,
(12:08):
That's what a prescription is, right, a permission. You got
your permission slip to take this medication that might harm you.
You need a medical person to review your case and
sign off on this particular product for you to take it,
(12:29):
because it needs as someone who's studied these drugs and
studied you, and we want to make sure that this
is safe and that you need it, and we want
to try and control the amounts that you get. So
go get your permission slip from the doctor. But a
(12:52):
lot of times, after a certain period of time, I
think it's five years, maybe ten years, a lot of
these prescription drugs are now over the counter or OTC
and you can go pick them up at your earliest
convenience without having to sit at doctor Levine's office for
three hours waiting to talk to him. Audrey from Vaider,
(13:16):
how you doing, Yes.
Speaker 3 (13:18):
Good morning. About a few weeks ago, I developed some
sore and redness and it was inflamed on the back
of my leg. So I went to one of the
local clinics and she diagnosed it as cellulitis. But the
(13:42):
strange thing about it was about a year ago I
had skin cancer taken off on the back of my
leg and that was the very same place where this
cellular light is developed. The scar was maybe about three
(14:04):
or four inches long, and I just found that kind
of weird that that's where it would develop. What do
you think about that?
Speaker 1 (14:14):
It is an unusual location for that particular condition. But
skin cancerlitis honestly can develop anywhere.
Speaker 3 (14:24):
I mean it can.
Speaker 1 (14:26):
The human body is very weird, unpredictable.
Speaker 3 (14:30):
Yeah, And it.
Speaker 1 (14:31):
Just takes a good physician or healthcare professional and have
a high index of suspicion as it pertains to cancer
or slitis to make that diagnosis. As I was talking.
Speaker 3 (14:44):
To the doctor, gave me around to the antibiotics in
about a week. It you know, the inflammation and the
soreness was gone.
Speaker 1 (14:55):
Well good, that's awesome that the system worked.
Speaker 3 (15:00):
Is Can I ask you one more question? Why do
they require a low fat diet for a PET scan?
Speaker 1 (15:16):
Low fat diet for PET scan? I'm not a radiologist,
and a PET scan is a specialized X ray test
that primarily is used in the cancer world to initially
help make a diagnosis of cancer as well as to
(15:38):
follow cancer.
Speaker 3 (15:41):
Doctor. I'm sorry, I'm in a low carb.
Speaker 1 (15:45):
A low carb diet.
Speaker 3 (15:47):
At ye, a low carb diet. I'm sorry, I got
the two make sed out.
Speaker 1 (15:52):
Well, that's okay. The as far as I know, my
basic basic understanding of PET scans is that it's it
is all built on the activity of the particular cell
that you're thinking of, whether it be a lung cell
or brain cell. And most yeah, most human cells operate
(16:17):
on sugar, right, They need sugar to operate, and the
PET scan is the way they do this scan is
they basically put some sugar in your bloodstream and they
see whether sugar goes. And the idea is that anything
that is needing a lot of energy, like cancer that
(16:44):
normally consumes a lot of sugar, consumes a lot of energy.
That sugar will go to that cell, and they sort
of attach a radioactive chemical to it, and so they
just sort of follow the sugar basically and take a
picture of your body and they see where all the
(17:04):
sugar is going. I'm assuming it has to do with
something like that. They don't want to they don't want
you to eat all this sugar and then they inject
you with sugar and it might complicate the results of
the test. I'm assuming it's going to be something like that.
It's a very crude explanation, but I'm assuming it has
(17:26):
to do with something like that. How many days prior
to the test that they tell you to eat a sugar.
Speaker 3 (17:33):
Diet the day before and the following morning it was
all okay.
Speaker 1 (17:42):
Like I said, I'm not a radiologist. I don't know
the fine details of that, but I do know that
PET scans is all about testing the activity of the cells.
And again, when there's hyperactivity or high activity of the cell,
it tends to consume more sugar in the bloodstream, and
(18:04):
so sugar then will go to that cell, and so
they will attach radioactive compounds to the sugar that they
inject and I see where it goes. And then they
take a picture of the body and depending on the
amount that's in the cell, they can say, ah, that's hyperactive,
(18:25):
and ah it's lighting up, and yes, more than likely
it is cancer because the amount of sugar that it
consumed and this amount of time is more consistent with
this versus that.
Speaker 3 (18:39):
So a PET scan is more detailed than a CAT scan.
Speaker 1 (18:46):
No, it's just two different X ray modalities and they're
looking at different things. The PET scan, like I say,
in my opinion, is more of a functional activity scan,
whereas a CAT is just a picture of the anatomy.
That's all. The CAT scan does same thing with an MRI.
(19:07):
It just takes a picture of the anatomy, that's all
it does, whereas a PET scan is more of a
picture of the activity of the human body. Like the
body is a machine and the PET scan is able
to look at the activity of the machine and see
(19:28):
if there's some particular area that's more active than others.
Because cancer is a very hyper cell, it's more hyper
than it needs to be because your brain, sell, your
hard sell, your liver cell is supposed to operate within
a certain boundary under control basically, and when that control
(19:52):
or when the control is lost and the cell is
hyper that's more consistent with cancer, because that's really what
cancer is. It's just hyperactivity of a cell. And normally
when it's hyper it it does not function very well.
It normally tends to spew out other toxic hormones and
toxic chemicals and that will then circulate through the human body,
(20:16):
which is why a lot of times if you have cancer,
you lose weight, you don't have a good appetite, you
don't feel good, just because the cancer is spewing out
all these toxic hormones in your bloodstream. As it is
very hyper and its activity, it's out of control, if
you will. So the PET scan can test sort of
(20:37):
that hyperactivity, whereas a cat scan and the MRI and
ultrasound they're just taking pictures of the particular part of
the human body. So you said lung, So most of
the time you would get a cat scan of the
lung and it's just a picture. It does not test
if it's functioning or not. Just it just it's a picture,
(20:59):
that's all it is.
Speaker 3 (21:01):
Okay, thank you, hopefully.
Speaker 1 (21:05):
Hopefully helps you out. And I didn't confuse you more.
Speaker 3 (21:08):
Oh no, that was good.
Speaker 1 (21:11):
Thank you all right, Audrey, I appreciate it. Doctors don't
know everything. I have to read just like everybody else
and keep up with it, which is why I loved
my career and I love my profession. I like reading.
I grew up reading a lot when I was in elementary.
I went to Blanchet Elementary here in Beaumont, Texas, and
(21:34):
we used to have the Riff program. I don't know
if you guys remember that. Riff Reading us fun and
like three or four times out of the year we
would go to the cafeteria and they would just have
all these books sitting there and we could get two books, anyone,
(21:54):
any two books you wanted. And uh, I don't know
what happened to that program. I don't know if it's
still around. Riff reading is fun, But anyway, I learned
to enjoy reading, and I do love reading. I don't
have a lot of time to read now because I'm busy.
I interact with a lot of my listeners out there.
(22:16):
I see them in the hospital, see them in the office,
and yeah, it's it's hard to get all that in
when you're you're doing other things. But yeah, go pick
up a book to Dan read anyway. Phone lines open
eight nine six KLV one hundred three three zero ko
if I'll be back in two minutes. All right, welcome
(22:49):
back to the dark Lavine Medical. Our phone lines are
open eight nine to six kV I one one hundred
three three zero kov I sitting here talking about poisoning
as well as pet scans, cat scans and reading. Yes,
reading is fun, riff. It's a great program. We need
to look up and see if that program is still around.
(23:12):
And a lot of people always ask like, well, how
much reading do doctors actually do once you get out?
I mean, we all know that medical education is long
and it's arduous, and you have to spend a lot
of time in the hospital and just reading and studying.
And I think most people get that. But once you
(23:32):
get out, you have your degree, you have your license,
you're out practicing. How much do you guys really have
to read? And it's sort of all over the place.
But there is what they call continuing medical education or
CME for short, and to have your license and to
(23:52):
be allowed to a lot of times work at hospitals
or certain medical facilities, they were require you to have
so many hours of cm E every year or every
two years, whether it be I think we up to
twenty five hours, maybe fifty hours. I think it's maybe
twenty eight hours a year, and so you have to
(24:16):
engage in some sort of what we call CME program
continuing medical education program that equals twenty six twenty eight hours,
which man and the way to do that is highly variable.
When I came out, a typical way of doing that
(24:38):
is to go to a conference, like a weekend conference,
and you'd get there Friday and you would spend maybe
you get there Thursday, and you would spend Friday, Saturday,
maybe Sunday in a lecture hall listening to various lectures
about various topics, and that was your continuing medical education.
(25:04):
You normally had to take off from work, you had
to travel, spend time away from the family. It was
sort of a big commitment, and that was the way
a lot of that was done. Now with phones and
the information how it spreads now, it's much easier. Most
doctors don't have to do that anymore. You can complete
(25:26):
CMME just sitting there in your office on your phone.
You can do it that way. They still had their conferences.
But again that's a lot of time, it's it costs,
and if you can just do it very easily with
your phone at your house, I mean, I mean, it
doesn't even compare. That's just one way to do it.
(25:49):
So doctors do have to keep up with sort of
what's going on out there, but they don't really tell
us what area of medicine to keep up with. I mean,
it's really up to us what we want to do
in terms of how we want to spend those hours.
They don't really dictate to us. You have to do this,
you have to do that, at least not yet. So
(26:11):
again that's sort of why you get different sort of
decision making and a different approach to a certain disease
process or certain medications. You might go to doctor Levine
over here, and then you don't like doctor Leavine and
go across the street and you get some other doctor
and they do it different. That's a lot of times
(26:32):
why you get that, or they dicnise you with this,
then you go to another person and dicnoise you with
something else. It has so much to do again with
what that practitioner has seen on a regular basis and
certainly their knowledge level, and it's just going to be
highly variable. There's really no mechanism in place for you
(26:52):
to know exactly what the knowledge of your practitioner is
when you see him. I mean, yeah, you can go
on line and look at the reviews and all that,
and there's a lot of controversy with these online reviews
whether or not it's real or it truly represents the practitioner,
and that that's a tough one as well. But there's
(27:13):
no mechanism in place to actually know what your practitioner's
knowledge base is, what their experience is when you see them.
Maybe in the future we'll have that, but we don't
have that now. And it's not that anybody's trying to
do anything wrong, it's just that the system is not
set up are geared yet to make every doctor the same.
(27:35):
I think they're trying to get to that point by
introducing some regularity in what each physician knows. You know,
if you're a surgeon, you're a medicine doctor, no matter
where you go in this country, you should sort of
be getting the similar sort of diagnoses and the similar experience.
(27:56):
They're trying to get that get it to that point.
It's hard dealing with human beings and a lot of
different attitudes. And each system is different, meaning that the
system at doct Levine's office is different from the system
at the major hospitals. The computers are different, and the
staffing is different, the culture is different, and all of
(28:18):
that sort of impacts what your experience is going to
be at a particular institution. And again, they're trying their
hardest every day to kind of make it the same.
Just like with when you go to a burger place,
right and it's a certain burger company, You're getting the
(28:39):
same experience at this particular company or burger business that
you get no matter where you go. You travel out
of town, you see those you see that sign, Aha,
I know what I'm going to get when I walk in.
So you walk in and you get that experience. They're
really trying to do that with medicine, and I don't
(29:00):
have a problem with it because a lot of medicine
is routine and we're seeing the same diagnosities. It's the
same medicines, it's the same X rays, whether it be
a PET scan or a CT scan, And I think
it does improve outcomes. It does introduce a sort of
a systemic approach in how to handle and manacings. If
(29:23):
you've ever had chest pain or heart attack, you know
there's a system in place called cardiac alert that has
been developed over the years so that when a button's
pushed that certain things fall into place automatically to get
this particular person seen in a systemic way. They're doing
(29:43):
that with strokes. Now sepsis. You've heard of sepsis? Right,
you listen to my show. You're Smart? Hey, Leonard from Houston?
What's going on?
Speaker 4 (29:55):
A couple of months ago, I spent two weeks in
the hospital. Since getting out, I had a real follow
with shortness of breath. I've been prescribed iron pills. I've
been eating the liver like I was told to do.
I ride the stationary bicycle. It doesn't seem to do
any It does seem to do some good, but it's
(30:16):
not fast enough. What more can I be doing to
get my strength back?
Speaker 5 (30:24):
Well?
Speaker 1 (30:24):
I guess one thing I want to make sure is
that your system is still working and that nothing has
happened since you left the hospital. So most of the
time we want you to see your healthcare provider within
a week of getting out of the hospital or rehab.
Let them listen to your lungs and your heart, do
(30:45):
a physical examination, and if necessary, do hsst X ray,
do labs to make sure that all looks okay, because
you could have developed a lung infection, you could be
more you could have an EMI, you could have a
hole in your chest, which we call a new mol thorer.
(31:05):
I mean, all these things can pop up just all
of a sudden, which can cause shortness breath, cause you
to feel bad, and you wouldn't know it unless you
went in and got checked out. But if all that
is fine, Leonard, Sometimes, yes, the ugly side of getting
older is that we just don't recover us fast. Just
(31:26):
it tastes longer, and I know it's super frustrating, but
we just don't bounce back as quickly as we did
when we were, you know, thirty years older, thirty years ago,
and it's just a more longer process of getting back
to your previous health, and unfortunately, sometimes you never ever
get back there for various reasons. Really, yes, well, so
(31:51):
that is.
Speaker 4 (31:51):
The hard doctor. I went to the hard doctor the
other day and he did whatever he did, and you're fine,
and come see me in three months. Yeah, I think Yeah,
to be good news.
Speaker 1 (32:01):
Absolutely, But I think you need to be patient and
just understand that the body just does not recover as
well as you get older. That is the essence of aging,
it really is. We don't repair ourselves as well, we
don't tolerate stress as well. We're weaker, and god, you know,
(32:24):
hopefully if you do have to be hospitalized, whatever is
happening to you can be fixed and you can get
out as soon as possible. Because the long as you
stay in the hospital, I mean, the weaker you're going
to get, the long it's going to take you to
get back on your feet. That's just what I've seen.
But it sounds like you're recovering in as good a
(32:45):
fashion as possible. Just you'd need a little bit more time,
all right.
Speaker 4 (32:49):
Well, if it's just if that's the answer, that's the answer,
that's a good guy, Okay.
Speaker 1 (32:54):
Buddy Lennon. We appreciate that. And I work in the
hospital every day and I talk to families every day,
patients every day about this exact issue of how the
human body reacts to a medical trauma or a medical stress.
(33:16):
How you can go from cutting your grass outside, driving
your car, going to church, getting your groceries, living independently, right,
paying your bills, cleaning your house. Two weeks ago, you
do all that, and then now all of a sudden,
you're in the ICU. You're fighting for your life and
(33:41):
you might not recover. I see that every day, and
it has to do with the aging process. It is
real and you need to respect it if you are
getting older, because it is a programmed aging issue. Your
(34:01):
body is programmed to do that. So your immune system
doesn't work as well, your blood vessels don't work as well,
your heart doesn't work as well. And when you get
medical stress and you need strength, you need endurance, well,
that aging process is they're putting a brake on all that.
(34:23):
That's why that happens, where you can go from two
days ago to now you're fighting for your life and
you might not recover, just because the severity of stress
is too severe. The body cannot tolerate it. See that
every day. That's why we talk about those vaccines. Phone
lines are open eight nine six Scalvy I one hundred
(34:45):
three three zero, Okayalvy, I'll be back in two minutes.
All right, welcome back to the dark Lavinion Medical. Our
phone lines are open eight nine to six Scalvy I
one one hundred three three zero kyo. Yeah, we have
a Michael from how can we help you?
Speaker 5 (35:02):
Good morning, doctor Levine. Yes, sir, I have ah my
middle toe on my left foot. Uh, I've been having
trouble with it. It's it looks like it's a callous.
I went and saw a skin doctor and he told
me that. I asked him, was reward or something? He said, no,
(35:26):
it looked like a callous. And he suggested that I
put a a tab on that he had and I've
been doing that, but it's not helping. Uh, and I'm
not sure if it's a calous or not. I had
a friend that had a similar problem. He went to
(35:46):
a foot doctor, and a foot doctor cut it out.
And but he's in another state and not particular doctor,
and what well, what do you know about callous is
on toes. It's on the tip like the pad portion
(36:11):
kind of a kind of sideways in my centered. I
actually cut it, cut it off about it six months ago,
and I was wearing a bandage on it and it's
seemed to go away. Finally i'd stopped with a bandage
(36:32):
and uh, it had healed up good. From where I
had cut cut it off. Uh, so I'm not sure
what I got. I don't know if I have a
callus or what. And so my question is is if
it is a calus, how do I get what? What
(36:53):
do you do for a callous? It's gotten painful now.
When I was wearing a bandage on it. When I
say bandage, it was band aids, a couple of band aids,
and it didn't bother me when I hand the bandage on.
But now I don't have the band the agon, it
(37:13):
does bother me. So I'm going to get I need
to go somewhere and get it fixed. And what do
you think?
Speaker 1 (37:23):
Yeah, most of the time with callouses, it just represents
a area that is receiving a lot of pressure and
friction that the body or the skin system reacts to
to basically protect itself. So, certainly as we get older
because of arthritis and other muscular scalular problems, the way
(37:46):
we walk puts pressure on certain parts of the toes
and the body reacts to that by forming that callous
or protection if you will, is what a lot of
times a callous is so that it can not be injured.
So sometimes, yeah, the callus can get large enough that
it needs to be trimmed, and that's a lot of
(38:06):
times what foot doctors will do is just going there
and just kind of trim it up so that it's
not so big. They have multiple little things that you
can do over the counter. A lot of times, these
topical patches that you can put on the callus to
chemically dissolve the callous. You can do that, like these
wart remover band aids that you can get that will
(38:31):
sort of enzymatically debreed the callous. And then yeah, certainly
going to see a foot doctor just to get an
exam and see if there's any way that they can
help you take pressure off that particular part of your
foot that's having the callus. So a lot of times
there's shoe inserts or what they call orthotics that they
(38:53):
can provide for you that you put in your shoe
so that when you walk, it distributes the pressure better
so that this particular area that's forming the callous doesn't
have as much pressure on it. And if not, then
you know, the callous will go down or I won't
get continue to get bigger. And then like I said,
you might have some sort of anatomical problem that needs
(39:15):
surgical attention, maybe helping you with your footwear and helping
you get into some shoes that are better for your feet.
So certainly working one on one with the foot doctor
of podiatrist would be the best thing to do.
Speaker 5 (39:32):
That callous. Well, first of all, when I wore that band,
it didn't I didn't have as much noticeable pain. But so, well,
you give me a good answer. I just what I
(39:56):
was going to say is that I really don't put
pressure on that toe. I don't. I just don't understand it.
Just it just doesn't make sense, Oh that there were
callous on that poe of changed shoes, check shoes, and
so I hope it's only a callous.
Speaker 1 (40:16):
Yeah, And that's why it's good to work with pediatris.
These are foot doctors and they are familiar with callouses
and bumps and all the things that happened with the
toes and the feet. So that's why you have to
work one on one with them. Yes, sir, you don't.
Speaker 5 (40:33):
I know you're in Beaumont, but you don't have a
recommendation here for one day.
Speaker 1 (40:41):
Just get with your primary and they will know where
the pediatrist.
Speaker 5 (40:44):
Are Okay, thank you very much.
Speaker 1 (40:47):
You're always very informed to appreciated. Michael, have a good day.
And yeah, callouses on the toes and the feet, And again,
I guess we don't spend too much time talking about
the feet. Are the toes. We talk about shoulder pain,
back pain, knee pain, right, but yeah, you can take
(41:09):
a look at those feet. They start to bend in
all sorts of different ways, and your toes start looking
a little odd in terms of the orientation of your toes.
And some people have pretty bad muscle scale the problems
of their feet. Remember, you're walking every day, so it's
receiving a lot of pressure every single day. And again,
(41:32):
depending on your weight and your overall general health, you
might start getting a lot of issues with your feet.
I've seen some pretty bad feet over the years, and
especially we all know about type two diabetes or type
one diabetes and when it causes nerve injury to your
feet and how that can leave your foot vulnerable to
(41:54):
injury just because the nervous system when a normal foot,
protects the foot from end a lot of times. But
when you lose the sensation, then again, the bottom of
the foot, the top of the foot, the side will
start to get all sorts of friction and pressure points
that it's not designed to handle until it breaks down.
(42:15):
And that's why a lot of times you can get
these ulcers on the bottom of your feet. A lot
of times patients are diagnosed with diabetes just because they
get an ulcer in their foot. They don't know why
they have it, but you check the numbers and their
sugar is sky high and they can't necessarily feel the
bottom of their feet, and so that's how that starts.
(42:36):
That's probably the most common cause of just sort of
ulcer formation of the feet in our country. But again,
just the muscle scalar system gets older, and the way
we walk changes because of the changes of the knees
in the back and our muscle mass, and if we're
getting pain when we walk, I mean, all that stuff
(42:57):
changes our gate gai t and then that changes where
your foot hits the pavement and the way you walk.
All that so you can start getting some skin breakdown
or callous formation in certain parts of of your foot,
and it's just a reaction that your foot has again
(43:18):
to toughen up, if you will, which is why if
you start walking barefoot all the time, you'll get a
lot of callous formation on the bottom of your feet
and it's just a reaction and certain degree is nothing
wrong with it. Your foot are tough enough and before
you know you walking on bare feet all the time.
I mean, we don't recommend that because there's all sorts
(43:40):
of things on the pavement, sharp metal, sharp metal items
that can get embedded in your foore. We don't recommend that,
but again that's what would happen. And sometimes yes, it
gets too large and you have to kind of clean
it up, shave it up. They have all of these
ensomatic debreatment band aid appliances out there. You can go
(44:02):
to the pharmacy doctor Shoals I think has a big
product line where you kind of fit the band aid
to the size and location of the callus and get
that thing down. And then yeah, pay attention to some
of your shoes. Again, not all shoes are created equal,
(44:23):
some are better than others. And again depending on your
anatomy and normal. A lot of times if you do
go to Padaca's, they'll do X rays of the foot
just to look at the orientation of your bones and
see if they can kind of make things right with
these shoe insarts called orthotics, which a lot of times
they design personally for your foot and how you walk.
(44:47):
I think they have some special equipment in their office
so that you can get tested to design that. So
you would sort of basically put these things in your
shoe every day and make you walk better so that
these calusys dom for them. And hey, foot problems can
turn into major problems. I mean, have you in the
(45:08):
hospital for two weeks, four weeks, six weeks getting ivy
antibiotics the pain. So you've got to protect your feet, especially,
like I said, if you have diabetes, we want you
to examine your feet normally once a day, just look
at the bottom of the feet and if your diabetes
is not well controlled, then certainly get to a foot
(45:30):
doctor maybe once a year, have a good exam, and
never ever ever walk barefoot if you have diabetes. Is
because man, so many things can get stuck in the
skin and cause infection and abscess and the crosis. We
see it every day. It's amazing. Anyway, thank you for
joining the edition of the show. Remember don't drink and drive.
(45:52):
Eat some vegetables, I say, cucumbers, but hell, you can
have anything you want. We'll see you guys next week.
Take Care app
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