November 25, 2024 • 41 mins
- Listen Saturday mornings at 8 as Dr. Msonthi Levine discusses medical issues and takes your calls on News Talk 560 KLVI. Dr Levine is board certified in Internal Medicine and Geriatrics. His office is located at 3080 Milam in Beaumont, Texas. He can be reached at 409-347-3621.
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Episode Transcript
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Speaker 1 (00:00):
It's a wonderful Saturday morning. Welcome to another edition of
The Doctor Love the Medical Hour. I'm your host, Doctor Levine,
taking phone calls from the students of kov I hear
in Beauma, Texas cross Street from Parkdale Mall, taking your
phone calls and trying to answer some questions about healthcare
and medicine since it is a very complicated, sort of
(00:24):
confusing experience sometimes unfortunately, and we're here for an hour
to try and help you understand and get some clarity
with any sort of topics or problems or questions that
you're having. As more and more you're getting more and
more information about all sorts of things, and sometimes information
(00:45):
contradicts itself. Everyone has sort of their position of opinion
on certain aspects of healthcare, what's right and what's wrong.
And I know all of us trying to stay alive
as long as possible. It's the mantra of the show,
stand alive. And how do I do that with all
the other distractions that I have every single day. So
(01:06):
give us a phone call. We'd love to hear from you.
Eight nine six kov I won one hundred and three
to three zero kov I Happy Thanksgiving We're looking forward
to the Thanksgiving holiday, a lot of excitement in the air,
getting fanily together and having our feast, as we say,
(01:28):
where we have that one or two days where we
can sort of do whatever we want to do in
terms of eating and drinking. It's fun, it's exciting. I'm
a big eater myself. I think about it all the time.
I'm certainly been around a lot of folks who they
can go all day without eating and be just fine
and happy. But for most of us, we get angry
(01:51):
anytime we go several hours without munching on something. And
so Thanksgiving is that one day where, man, that is
the focus of the day is to just eat everything,
all those goodies and favorites, pastries, cakes, pies, corn bread, dressing, gumbo,
(02:12):
just man, what a wonderful day. And then sit around
and watch some games and just reminisce with family and
just have a good time. And hopefully the weather it's
good normally it's been pretty good the past few years.
You know where it's sunny, but it's got a little
coldness to it, but clear crisp Sonny. You know, whether
(02:34):
you can drive in, whether you can go outside and
toss the football around and run around and get some
good videos that you can laugh at. You know, a
little simple accidents that happen, but hopefully no one gets injured,
and no drinking and driving. Right, It's here to have fun,
(02:56):
but we don't want you to go on the road
if you do, unfortunately drink some alcohol and it gets
away from it a little bit, which happens with our
festive holidays. We don't want you drink it and drive
and hand those keys over. I'll just go ahead and
call an uber or a taxi or just don't get
in that road just because, yes, alcohol is a toxin.
(03:19):
I don't know that people kind of understand that. We
see a lot of patients in the hospital who unfortunately
are struggling with the consumption of alcohol, which has become
more plentiful and easy to get. I do remember as
a young person it was not really something a lot
(03:41):
of people did. You know, beer was kind of around wine.
But it just seems that more people are doing that
socially in the restaurants, you know, more people are going
out to eat and it's more celebration. So you have
to be careful there and not let it get away
(04:01):
from what you can because you know drinking that it
just impairs your judgment, empowers your behavior, and you don't
want to operate a motor vehicle in that situation. That
requires a lot of thinking and a lot of quick
decision making, and you have to be careful. So if
you do decide to indulge, you know, be careful out there.
(04:27):
We don't want any accidents and we want this to
remain a festive time of year. We sometimes get into
that driving issue with our elderly patients who unfortunately do
start to develop physical and mental deficiencies. Where again, operating
a big vehicle like a car, I guess we don't
(04:48):
think of it as anything that's huge or dangerous, just
a car. You get used to it, but yes, it
can cause harm. It can harm yourself, it can harm
your neighbors and the general public. We get into this
topic a lot when we talk about dementia. Are just
an elderly patient, maybe getting up in age and physically
(05:10):
may not have the strength or vision, hearing, those sort
of things which you all need to operate a motor vehicle,
and it's sometimes tough taking those keys away from your
mother or your father, and they sometimes fight us when
it comes to that, right, they get upset and angry
(05:30):
that their independence is being taken away from them, and
they don't like it, and they fight so and I
understand that. You know, they've been independent for many, many years,
and all of a sudden, their children are sort of
ganging up on them and wanting to take away their
freedom to drive to church, or drive to the supermarket,
(05:53):
or just drive for their friend's house when taking the
keys from the vehicle away. But a lot of times
it's a good idea. I get asked that question all
the time when family members come in with patients who
again may have been recently diagnosed with Alzheimer's dementia. Remember
that's a very very prevalent disease and should become more
(06:18):
prevalent as time progresses. As we get better at treating cancer,
we get better at treating cardiovascular disease. Again, these are
the diseases that are number one and two in competition
dementias three or four. And as you get older, that's
the biggest risk factor a lot of times for the
(06:39):
development of dementia is just getting older. Our nervous systems
just have a degenitive process, just like everything else. And
I'm patients hate hearing that word. They hate when I say, oh,
it's just the aging process, and they come in with
the physical complaint and we have to bring that up.
(07:02):
But the aging process is real and we need to
respect it, which is why a lot of times I
forgot to mention my vaccines. Right this morning, you almost
forgot about that. That's one of the systems that declines
as we get oldest, that immune system. So it's there
to protect us, and for the most part it does
(07:24):
a wonderful job, but that's one of the big risk
factors as we all get older. Sis these infections that
come about, whether it be a lung infection which we
call pneumonia, or a bladder kidney infection which we call
a urinary tract infection, or skin infection, or we get
(07:44):
back to her in our bloodstream, we call that bac
to reemia, which is never a excuse me, a good thing.
But even just abdominal infections sort of like a gall
bladder or an appendix, are just a bad infection. Call
that diverticulatis. I mean, just that immune system just as weak.
(08:05):
And we just started getting all these sorts of infections.
So the vaccine system is a way to sort of
lessen the possibility of having a severe infection. Had this conversation,
you stay with a patient of mine. Again, just remind
all the listeners and the patients, and they still get frustrated.
You know, I got this vaccine last year and I
(08:26):
still got infected. I still had to come to the
doctor's office. I don't like vaccines. It didn't work for me.
And I still have to remind my patients. And I
want to remind you that the way these vaccines are engineered,
like the COVID and the flu and pneumonia, is that
they keep it to a minimal disease. They lessen the
(08:48):
severity because really, at the end of the day, we
just we don't want to be hospitalized and we don't
want to have to take a bunch of meds or
potentially have to be on a ventilator or potentially not
make it or not survive. And again, as I mentioned
to you, the aging process is real your human systems.
(09:13):
Again that all the systems work together and coordinate it
in a coordinated fashion. And when you get older, that
aging process kicks in. All that stuff doesn't work as
well as a system. It becomes very dysfunctional, very chaotic.
And this is how you hear this story all the time,
where you know, Grandma was doing fine last week, she
(09:34):
was up and walking around, doing good, driving, playing outside,
and now she's in the hospital and the ventilator and
we don't know if she's going to make it. That's
why that happens, and it's hard for families to understand that,
but it's very easy for me to understand it because
I see this over and over again. I've seen it
(09:54):
over and over again over twenty years of treating patients
in the ICU. Is that aging process is one of
those things that's in the background and we might be
able to function okay, but when there's a time of crisis,
you know, like a covid infection or pneumonia infection, and
(10:17):
our bodies need to be strong and have endurance and
be able to tolerate stress, which again I call a
lot of these medical crisises medical trauma because that's a
lot of times what it is. It's just this very severe,
acute event where your body really needs to have some
(10:38):
tolerance and some endurance and it needs to be strong,
and unfortunately, getting older, it takes away from that and
the chances are if you get a severe traumatic medical event,
you know, you may not come out of that, or
it may leave you with there's some significant chronic issues
(11:03):
that you have to deal with, and that's why we're
doing our best to reduce that possibility. And vaccines is
the way to do that. Is it free of potential issues?
Speaker 2 (11:16):
Well?
Speaker 1 (11:16):
No, I mean nothing is in this world? Yes, sir,
I hear you.
Speaker 2 (11:24):
Hello, Hello, Hey, Bob, good morning. Hey. I'm not to
ask you. Hey, can you hear me?
Speaker 1 (11:31):
I got you go ahead.
Speaker 2 (11:33):
I'm got to ask you about salt substitute any clinical
data on a it's a fact.
Speaker 1 (11:43):
All right, you said, salt substitutes. Yeah, yeah, you know.
As you know, high pertension big problem in our country,
is a risk factor for cardio vascal disease. So over
the years we're trying to figure out how do we
were deduce the prevalence of hypertension and if you do
(12:03):
have higher pertension, how do we help you manage that.
So salt and take has been recognized as a risk
factor that can make high pertension worse or hard to control,
or even introduce the development of hypertension, and so there's
been a huge movement over the past many or twenty
(12:23):
thirty years, even before I became a physician, to limit
salt consumption, because I'm assuming this is probably before me,
A lot of times the average American would introduce salt
to their food when the food hit the table is
a way of seasoning or making the food taste a
(12:45):
certain ways. This is what they're accustomed to. They would
add salt and pepper when the food hit the table,
and that was recognized as a big risk factor for
the development of hypertension. So the food industry came up
with salt substitutes where it sort of tastes like salt,
(13:05):
but it's not really salt, almost like artificial sweeteners are today.
As it pertains to sweetness and sugar. A lot of
Americans consume a lot of sweet items. They eat sweet things,
they drink sweet things. But we know that consuming sugar
all the time is unhealthy, and so hey, we have
(13:26):
salt substitutes. So I'm sorry, we have sweetener substitutes or
sugar substitutes, which is similar to a salt substitute as well.
What is my understanding of that is that, yes, it
can be sort of a different alternative if you'd like
to salt your food. However, certainly I think at the
(13:48):
end of the day, most physicians would just recommend you
not use any salt substitutes, try not to put a
lot of salt in your food in terms of how
it's prepared, and certainly don't do it when you're and
it hits the table. So still unhealthy in my opinion
to include a lot of salt in your diet. And
(14:10):
we still want you to limit any sort of salt
or salt substitute as it pertains to that. So I
don't know that there's been a head to head study
that has compared if you do salt and then you
do salt substitutes, what are the outcomes. There might be
something out there like that, But from my standpoint, my
(14:33):
message to any patient of mine is, no matter what
sort of salt it is, real thing, old thing, artificial,
it's probably not healthy for you, and you should not
be engaging in that behavior if you want to be healthy.
That would be my message.
Speaker 2 (14:49):
I thought, Yeah, I thought you'd stay that. Yeah. Remember
back in the sixties in high school when we ate
them like candy, that's right, football, that's right. We damn
those things, you know.
Speaker 1 (15:02):
Yeah, absolutely. Yes, That's what's so cool about medical education
and medical science. We're always learning new things and understanding
that some things that we recommended probably not good for us,
and we change. So that's what that's why I like
the profession. We're always sort of changing and evolving and
maturing and figuring the things out. So yeah, try to
(15:24):
limit your salt intake. That would be the good thing,
all right, Bob. We appreciate that that question, just because
you know, I don't hear a whole lot about including
salt in the diet. You have understand that more of
us are eating out more often than not. We we
don't really cook a whole lot anymore, which we have
(15:45):
to get back to doing our own cooking, just because
when you eat out all the time, there's probably going
to be more salt and more sugar and more starch
in the food, and it's just better to prepare yourself.
Leonard from Houston, how can we help you?
Speaker 3 (16:05):
Do you answer dental type questions?
Speaker 1 (16:09):
I certainly can try. What's going on?
Speaker 3 (16:12):
I want to see my dentists two weeks ago and
she said that one of my teeth that has a
cap on it has become infected and she sent me
to a specialist and he confirmed that it's infected and
all that, and they're decide that it needs to be removed.
And I don't understand why they can't take off the cap,
treat the infection, and put the cat back on and
(16:34):
I don't have to lose the tooths.
Speaker 1 (16:38):
Well, Leonard, you're right. I'm not a dentist or our
dental surgeon, but I understand some sort of basic concepts
of infection, and a lot of times when a certain
structure of the body becomes infected, the bacteria have a
way of attaching themselves to that surface or that material,
(16:58):
and they sort of stay there, and you can treat
with antibiotics and it seems like the infection goes away,
but there is a lot of times still a presence
of the bacteria there such that if you continue to
use that same surface, or you put something on top
of the surface, the infection will come back. So a
(17:19):
lot of times, as it comes to artificial materials in
your mouth or anywhere else, a lot of times that
it all of it just has to be removed. You
just got to get rid of everything, because the bacteria
will attach itself to that surface and it'll figure out
a way to stay there and it won't go away,
and the only way to get rid of it is
just to remove whatever it's attached to and sort of
(17:41):
start over.
Speaker 3 (17:43):
The cap has been on there forty maybe fifty years.
It's so long a hell, I can't remember when it
was put on. It's never caused me any trouble. It
doesn't hurt. They tapped on it with a hammer or
whatever it was, didn't hurt. I just don't understand why
it has to be removed. I'm resistant to that concept.
Speaker 1 (18:03):
Yeah, you know, certainly, if something's been there for twenty
five years, is probably worn out and it's probably not
as functional as it used to be, and it's probably
new stuff out in the market, new material that the
dentists and the dental surgeons are using, and probably just
trying to get you up to speed with you know,
(18:24):
what's new and what's out there. And yes, it might
be cumbersome having all that done, But just as we
were mentioning about salt and salt substitutes, we learn new
things about all these materials and surgical techniques. And I
think the dentist is just doing its job and trying
(18:44):
to get you up to speed with you know, what's
the common understanding of how to deal with the current problems.
So I would probably if I were you, be a
little bit more open minded as it pertains to that,
and they're just trying to take care of you. You
can always get a second opinion from a different dentist.
Speaker 2 (19:03):
Uh.
Speaker 1 (19:04):
If if you're not quite happy with what you're listening to, you.
Speaker 3 (19:08):
Send me to a specialist, nindrogontist or something like that.
Speaker 1 (19:11):
I can't orthodontist, but.
Speaker 3 (19:14):
That guy said that it's infect and has to be improved,
and I don't. I still don't understand why I have
to take the tooth.
Speaker 1 (19:23):
Well, yeah, again, probably the tooth is the root of
the problem, if you will just our d Yeah, it
is our you know, our We don't talk a lot
about dental health and dental hygiene on this show, and
that's unfortunate, and we don't talk a lot about it
in the office, which is unfortunate. But your your teeth
(19:44):
and your gums, it's it's a really important part of
your health. And yes, as we get older, it's part
of the skin system. It does have a sort of
a degenitive wearing out process to it. And so we
lose our teeth, our teeth become more rotten, they crack,
they break, and again when something a lot of times
(20:04):
becomes infected, there's just it's just got to be everything's
got to be taken out, cleaned out so that the
tissues can heal. It's it's hard to leave infected material behind.
I think if it has an abscess, you know, get
you have to get what they call an incision and drainage,
(20:24):
or you have to get lanced. It's sort of that
same concept where the infection is so dense and it's
so widespread you have to just sort of cut it
open and just really wash it out. No different from
the mouth. And I think they've just learned over the
years that they can't do it halfway, like they got
to go all or none. And so that would probably
(20:46):
be my understanding of that. You know, the infection is
deep seated and they have to get all that infected
material out of there if they want this to get better.
Otherwise it'll fester and it will cause more damage to
the gums and the jaw and the bone and pain.
(21:06):
And sometimes the infection can get into your system and
we call that stepsis. So I think a lot of
times when it comes to mouth infects, you want to
get in there sooner rather than later. So that's sort
of my understanding of that. So I think if I
were you learn it, I'd go ahead and get it
in and just get it over with. Oh I'm sorry, Leonard,
(21:29):
sorry to hang up on you. I thought you were done.
Phone lines are open eight nine six kalv I won
one hundred and three three zero Kovy. I'll be back
in two minutes. All right, Welcome back to Dograly Meta.
(22:03):
Our phone lines are open eight nine to six kilva
at one hundred and three three zero KI. Happy Thanksgiving. Yeah,
that's why everybody's looking forar to the Thanksgiving Day where
we just kind of hang out and just gorge all
day and eat and watch football games. What a wonderful day.
And hopefully you and your family are getting ready for that,
(22:23):
you know when they were, you know, forget what the
doctor says. You know, you can have fun. But certainly, yeah,
dental hygiene. We don't talk a lot about that, but
it's important. It really is important, just because you can
get these sort of low grade infections in your mouth.
We call that ginge of vitis and just can't communicate
(22:47):
with your system in general, just because it is sort
of a low grade infection and the body is sort
of attached to your gums and your teeth. And certainly
there's been a lot a lot more growing awareness than
the medical community that yes, maybe that's something that we
need to start just mentioning to patients during your office visits.
(23:08):
You know, we have limited time a lot of times
in the office to get everything in, and the insurance
company is sort of understand this, and more and more
the insurance companies are sending representatives of the insurance company
to your house, normally medical staff, normally nurse practitioners to
(23:30):
come out and in the convenience of your home without
all the rush is to just kind of sit down
and chat about some highlighted issues or topics as it
pertains to your health, just because they know that when
you go to your doctor's visit, things might get overlooked
or missed or just run out of time and you
(23:53):
don't really get in that basic information that they're trying
to get in. It's just basic, basic stuff that really
can and make a difference in terms of your health
and meaning your blood pressure, your cholesterol, your mammogram, your
PSA level, colonoscopy, just really basic stuff that unfortunately, when
(24:15):
you go into your doctor's office, your healthcare profession's office,
you know you got about ten minutes or so. I
think most people will sort of know that it's pressurized time.
They only have so much time with the practitioner, and
people are starting to sort of prepare themselves for their visit.
You know, they'll write things down. I see that a lot.
(24:35):
They have sort of a list of what's on their
mind so that they don't forget. I think that's a
good habit. But trying to fit in the conversation about
your dental hygiene, I don't know that that's been talked
about too much or put on the radar of the
insurance companies, but it's certainly something that you should do,
(24:56):
is go and visit your dentist at least once a
year or every two year years, something along those lines.
Because again, as you know, every time you eat or drink,
your teeth and your gums are getting exposed to that
In a film, film can develop over the teeth and
the gums, and we call that plaque, just like the
plaque and the blood vessels. I don't know they're the
(25:17):
same composition, but it's the same term we use. That
build up or plaque develops on your teeth and your
gum line, and if it's not cleaned or scrubbed on
a regular basis, then it certainly can generate a low
grade of inflammation, which we call ginger vitis. A lot
of times, if you sort of look at your gum line,
(25:38):
it looks a bit more red or you can sort
of see some debris or discoloration along that line, which
a lot of times it's just plaque. Normally it's white.
And the thing that helps with that for the most
part is just flossing. Flossing every day, which I've learned
to do. Wasn't really introduced to flossing early on, but
(26:02):
certainly I do that now every single day. Just kind
of understand the process of plaque development better, and certainly
it helps keep your gum line and your teeth and
your gingeva as we call it, as healthy as possible. Certainly,
don't forget about brushing, but certainly these medical issues that
(26:23):
we talk about, diabetes, hypertension, high cholesterol, the metabolic syndrome
that a lot of patients get into because of the
types of foods and beverages that we're consuming. A lot
of times we'll start attacking the gum and the teeth
as well, and you can get gingibal infections. You all
sort of know those symptoms, just the pain and the
(26:45):
swelling that can happen in the gum line. And it's
hard to ignore it, right because you know, our faces
and our nose and our mouth has a lot of
nerve endings, and it's a hypersensitive area as opposed to
the hand or the back, not as embedded with nerve fibers,
(27:05):
and so when something is hurting there, it doesn't bother
us as much, but certainly in the face and the
nose and the mouth, man, when you get pain there,
it's very very irritating. And so if you've ever had
an infection there in that area, you know what I mean.
And a lot of times you have to start off
with antibiotics and get to your local dentist. So, yes,
(27:26):
if that's not something you do, that can be a
part of a healthy lifestyle, is to go to your
dentist on a regular basis and get a checkup and
make sure everything is okay. And you know, the structures
in there are very tight and a lot of times,
I say, when you get a deep seated infection or
an abscess, so you've had sort of this chronic low
(27:48):
grade gingible inflammation which we call ginger bvitis for a
long time, it kind of eats away at that structure,
you know, the gumline and the tooth and the root canal,
and sometimes the infection is so deep in the root that, yeah,
it has to be cleaned out. I think that's what
a root canal is. Not a dentist, but I think
(28:08):
that's what that is. Where they go in there, they
just have to clean everything out otherwise it'll sort of
keep getting deeper and deeper and more aggressive, and so
they just have to just make a standstill and get
all that junk out of there and sort of replace
it and repair it. And they have their ways of
(28:28):
doing that. But it's like with anything else with abscesses.
You know, we're getting pacemakers and defibrillators and hip joint replacements,
knee joint replacements, and it's no different with these man
made devices that are now embedded in our soft tissue,
whether it be a pain pump as well. When those
(28:51):
devices get infected. Unfortunately, the treatment of choice is a
lot of times those devices have to be taken out
just because when the bacteria gets on the surface of
this foreign material or this man made device, it just
doesn't want to go away. I mean, it attaches and
(29:13):
it stays there, and you can get hit with a
bunch of antibiotics, and while you're in the antibotics, everything
is hunky dory. But as soon as antibiotics goes away,
the bacteria, which again is hard to remove from that surface.
They normally generate what they call a biofilm, which is
almost as a layer of nutrition and support, if you will,
(29:37):
for the bacteria to survive on that surface. It's think
of it as a nest for the bacteria to live.
They generate this biofilm, and we haven't figured out a
way to eliminate this biofilm. Nonetheless, so once the antibiotics
go away, the biofilm is still there and the bacteria
start to flourish, and then you get the infection again.
(29:59):
So a lot of time a treatment for these pacemakers,
these the fribladers, the pain pumps, and unfortunately, yes, sometimes
these knee joints and shoulder joints, hip joints. Man, it's
got to be removed as well as back surgery. I
forgot about that. You know, maybe you had some spinal
stenosis and you had some herni diss it's pinching on
(30:22):
your nerve, and you underwent back surgery, and then you know,
a week later, two weeks later, a month later, you
start getting some drainage from that area. The wound opens up,
and then you go into the er or your your
surgeon and find out you have that back til infection
of the what we call hardware. And yeah, sometimes that
stuff has to be removed because otherwise it just will
(30:45):
not get better and it'll stay infected. It can really
sideline you for a whole year, you know, because a
lot of times you have to undergo a couple of surgeries,
you have to be hospitalized a bunch of times, you
need to be on antibiotics. You can't be at work
getting antibiotics, and it can really be a mess. Unfortunately,
(31:07):
when you get these deep seated soft tissue infections from
previous surgery are just spontaneously. As I talk to you
about the immune system, we do see patients that come
in just spontaneously with an infected shoulder or an infected joint,
or an infected heart valve, which we call endocarditis again
(31:29):
because that immune system is not as robust and maybe yeah,
you didn't get to your dentist quite on time. And
that bacteria that's in your mouth now you have gingerful inflammation.
And that bacteria gets in a bloodstream and it travels
around your body and it sort of finds this weak
area in your body, and certainly the heart valve if
(31:50):
you've had diabetes or high potensional high cholesterol, your smoke
over the years the surface of the heart valve. So
again just to wear and tear of the human body,
the surface will become very rough and more prone to
getting seated by bacteria that's floating around in your system.
Again from again bad ginger vitis. So you come in
(32:13):
with just don't feel well, fever, maybe achiness, and we
do a workup and you have blood I'm sorry, back
to in your bloodstream and then we find it's on
your heart valve and then there you go. You know,
that's a lot of times how that can sometimes happen
just spontaneously. No vaccines for that, but certainly you get
the point is one thing can lead to another leads
(32:34):
to another, and that's what doctors do all day is
try to discover those connections. Phone lines are open eight
nine to six kalv I one one hundred and three
three zero klv. I'll be back in two minutes. All right,
(33:08):
welcome back to TC with and madcour Phone lines are
opened eight nine six kvy I won one hundred and
three three zero kova. Happy Thanksgiving and hopefully you're having
a good day. Good Saturday morning, Bill from Beaumont. How
can we help you?
Speaker 4 (33:22):
Bill? I mean doc. Yeah, I have a swelling in
my left leg and I was wondering what I can
do to get it down. I was told I'm probably
got gut, but I don't know about that. But it's
sometimes the swelling gives me some discomfort, but most of
(33:47):
the time I can get by with it. But never
had it before.
Speaker 1 (33:53):
How long have you had it?
Speaker 4 (33:56):
Probably ten days, two weeks.
Speaker 1 (34:00):
Have you tried anything for it?
Speaker 4 (34:03):
No. I've tried to raise my leg up so the
fluid or blood whatever it is, would drain down, and
that did help to a certain extent.
Speaker 1 (34:15):
It's both sides, like left and right, or is just
one sided.
Speaker 4 (34:21):
It's my left leg.
Speaker 1 (34:26):
Okay, so it's more swollen than the right leg, yes, okay, Yeah,
A lot of times when it comes to the swelling,
which we call a edema, is a medical term for that.
A couple of things that we like to rule out.
One is what we call a DVT, which stands for
(34:47):
deep vein thrombosis. It's a blood cloth. That's the one
big thing we'd like to rule out, and that can
be easily done with an ultrasound and most minor care
and emergency departments have that availability. It's very easy to do.
And I would say if it's been there for two
(35:08):
weeks and it's not going away, that would be my
primary concern, and so we would recommend that you get
that checked out today because if there is a clot,
you need to be on blood dinners because if the
clot is not treated, then the clot gets bigger and
bigger and bigger, and it can then travel to your
(35:28):
lung and call and cause what we call a pulmonary
imbalis or PE for short. Yeah, So it can can
get pretty harry there for a while. So if you
do have swelling, something that is causing it and it
needs to be discovered, and so that would be my
top concern.
Speaker 4 (35:51):
Should I go through my cardiologists or my primary opposition.
Speaker 1 (35:57):
Whoever can get to you evaluated soon. This is what
I would do, whether it be your cardiologists or your primary.
Your primary should be able to handle that. But again,
if the swelling has been there for a couple of
weeks is not going anywhere, you can probably go to
a minor care or an er free standing Beaumady R
or Exceptional and they can take care of that for
(36:19):
you today, so you don't have to wait.
Speaker 4 (36:21):
Okay, Doc, thank you and appreciate your show.
Speaker 1 (36:28):
Absolutely. Bill, We'll appreciate your phone call, and we'll go
on our last breakfall lunch open eight and on Sixcalvy.
I want one hundred three three zero kalvy. I'll be
back all right, Welcome back to o'claviene Medical. Our phone
(36:50):
lines are open eight on six kalvy. I want one
hundred three three zero o ko v. I time for
li in at almost at the end of the show, I
want to thank all the call is for their calls
in questions. That's why we're here trying to help you
answer some of those lower extremity swelling or what we call
a dema or peripheral edema, that's another term for that
(37:13):
is extremely extremely common in this country. And yes, at
the top of the line, we want to be sure
you don't have a clot or throumbus. Remember, as we
get older, I keep talking about this, and I'm not
trying to make you sad, but just make you aware
that that process is real. As we get older, it
(37:36):
is real. Things are changing. Your system is working differently,
it's operating differently. And one of the things other than
the immune system declining, is the blood vessel system. And
the blood system itself is more prone to one clotting
and two bleeding both sides right, And when it clots,
(37:59):
it forms a blood boulder that basically prevents blood from
flowing forward, and that normally causes lack of blood flow
to a certain organ or a certain tissue bed, and
it causes what we call a schemia that's sort of
a metabolic result of lack of blood flow. And most
(38:23):
of the time patients know they have a schemia because
something stops working, they have pain. It looks different, but
with a deep vein thrombosis, it's in the venus system,
so because there are a lot of veins in the
venus system. If one clots off, the blood just sort
of goes around the clot initially, and so you might
(38:43):
have minimal symptoms. But as it gets bigger and bigger
and bigger, then more veins sort of get clotted off,
and your extremity normally gets more congested, and that's what
causes that swelling or dima because of blood can't flow
and you start getting backflow of blood and it will
(39:05):
cause some congestion of the tissue, which is what a
dema is. And so most people will see, hey, this
is swollen, and it just has to do with lack
of blood flow, and we normally pick that up on
an ultrasound can be done in most physicians' offices and
very easily at any sort of freestanding radiology business. We
(39:27):
have a lot more of those around where you don't
even have to have insurance, and the prices are very
reasonable to get basic testing done, blood tests, ultrasounds, Whether
pricing is really reasonable that you can get that done,
but certainly you want to know about that. It's not
something you want to put off. So if you have
that swelling to one side of your ankle or your leg.
(39:50):
You want to go ahead and get that venus ultrasound
and see what's going on with your circulation. Other than that, certainly,
infections can cause sort of this what we call unilateral swelling.
But when organ systems, certain organ systems don't work, like
the kidney system, the heart system, the liver system, they
(40:14):
can also cause congestion of blood flow and you start
getting the swelling of the lower extremity. Medications I forgot
about those can sometimes be the culprit. Some of our
blood pressure medicines and medicines we use for pain control.
Diabetes can sometimes generate a little swelling in one part
(40:37):
of your leg or the other, and certainly you have
to get to your primary care phcisian's office and get
that checked out and get some lab to see if
there's any problems with your kidney or your liver that
might be causing the swelling. But it could just be
what we call venus insufficiency, meaning just your veins and
(40:58):
your legs are just worn out out and don't work,
and that blood flow is sluggish and you start getting
that congestion and so you start getting swelling. But certainly
it's a symptom of something and it needs to be
figured out. So go get it figured out. Don't wait.
A lot of medical outlets have opened twenty four as
they seven. This weeks happen Thanksgiving, don't drink and drive,
(41:19):
have fun. We'll see you guys next week
It's a wonderful Saturday morning. Welcome to another edition of
The Doctor Love the Medical Hour. I'm your host, Doctor Levine,
taking phone calls from the students of kov I hear
in Beauma, Texas cross Street from Parkdale Mall, taking your
phone calls and trying to answer some questions about healthcare
and medicine since it is a very complicated, sort of
(00:24):
confusing experience sometimes unfortunately, and we're here for an hour
to try and help you understand and get some clarity
with any sort of topics or problems or questions that
you're having. As more and more you're getting more and
more information about all sorts of things, and sometimes information
(00:45):
contradicts itself. Everyone has sort of their position of opinion
on certain aspects of healthcare, what's right and what's wrong.
And I know all of us trying to stay alive
as long as possible. It's the mantra of the show,
stand alive. And how do I do that with all
the other distractions that I have every single day. So
(01:06):
give us a phone call. We'd love to hear from you.
Eight nine six kov I won one hundred and three
to three zero kov I Happy Thanksgiving We're looking forward
to the Thanksgiving holiday, a lot of excitement in the air,
getting fanily together and having our feast, as we say,
(01:28):
where we have that one or two days where we
can sort of do whatever we want to do in
terms of eating and drinking. It's fun, it's exciting. I'm
a big eater myself. I think about it all the time.
I'm certainly been around a lot of folks who they
can go all day without eating and be just fine
and happy. But for most of us, we get angry
(01:51):
anytime we go several hours without munching on something. And
so Thanksgiving is that one day where, man, that is
the focus of the day is to just eat everything,
all those goodies and favorites, pastries, cakes, pies, corn bread, dressing, gumbo,
(02:12):
just man, what a wonderful day. And then sit around
and watch some games and just reminisce with family and
just have a good time. And hopefully the weather it's
good normally it's been pretty good the past few years.
You know where it's sunny, but it's got a little
coldness to it, but clear crisp Sonny. You know, whether
(02:34):
you can drive in, whether you can go outside and
toss the football around and run around and get some
good videos that you can laugh at. You know, a
little simple accidents that happen, but hopefully no one gets injured,
and no drinking and driving. Right, It's here to have fun,
(02:56):
but we don't want you to go on the road
if you do, unfortunately drink some alcohol and it gets
away from it a little bit, which happens with our
festive holidays. We don't want you drink it and drive
and hand those keys over. I'll just go ahead and
call an uber or a taxi or just don't get
in that road just because, yes, alcohol is a toxin.
(03:19):
I don't know that people kind of understand that. We
see a lot of patients in the hospital who unfortunately
are struggling with the consumption of alcohol, which has become
more plentiful and easy to get. I do remember as
a young person it was not really something a lot
(03:41):
of people did. You know, beer was kind of around wine.
But it just seems that more people are doing that
socially in the restaurants, you know, more people are going
out to eat and it's more celebration. So you have
to be careful there and not let it get away
(04:01):
from what you can because you know drinking that it
just impairs your judgment, empowers your behavior, and you don't
want to operate a motor vehicle in that situation. That
requires a lot of thinking and a lot of quick
decision making, and you have to be careful. So if
you do decide to indulge, you know, be careful out there.
(04:27):
We don't want any accidents and we want this to
remain a festive time of year. We sometimes get into
that driving issue with our elderly patients who unfortunately do
start to develop physical and mental deficiencies. Where again, operating
a big vehicle like a car, I guess we don't
(04:48):
think of it as anything that's huge or dangerous, just
a car. You get used to it, but yes, it
can cause harm. It can harm yourself, it can harm
your neighbors and the general public. We get into this
topic a lot when we talk about dementia. Are just
an elderly patient, maybe getting up in age and physically
(05:10):
may not have the strength or vision, hearing, those sort
of things which you all need to operate a motor vehicle,
and it's sometimes tough taking those keys away from your
mother or your father, and they sometimes fight us when
it comes to that, right, they get upset and angry
(05:30):
that their independence is being taken away from them, and
they don't like it, and they fight so and I
understand that. You know, they've been independent for many, many years,
and all of a sudden, their children are sort of
ganging up on them and wanting to take away their
freedom to drive to church, or drive to the supermarket,
(05:53):
or just drive for their friend's house when taking the
keys from the vehicle away. But a lot of times
it's a good idea. I get asked that question all
the time when family members come in with patients who
again may have been recently diagnosed with Alzheimer's dementia. Remember
that's a very very prevalent disease and should become more
(06:18):
prevalent as time progresses. As we get better at treating cancer,
we get better at treating cardiovascular disease. Again, these are
the diseases that are number one and two in competition
dementias three or four. And as you get older, that's
the biggest risk factor a lot of times for the
(06:39):
development of dementia is just getting older. Our nervous systems
just have a degenitive process, just like everything else. And
I'm patients hate hearing that word. They hate when I say, oh,
it's just the aging process, and they come in with
the physical complaint and we have to bring that up.
(07:02):
But the aging process is real and we need to
respect it, which is why a lot of times I
forgot to mention my vaccines. Right this morning, you almost
forgot about that. That's one of the systems that declines
as we get oldest, that immune system. So it's there
to protect us, and for the most part it does
(07:24):
a wonderful job, but that's one of the big risk
factors as we all get older. Sis these infections that
come about, whether it be a lung infection which we
call pneumonia, or a bladder kidney infection which we call
a urinary tract infection, or skin infection, or we get
(07:44):
back to her in our bloodstream, we call that bac
to reemia, which is never a excuse me, a good thing.
But even just abdominal infections sort of like a gall
bladder or an appendix, are just a bad infection. Call
that diverticulatis. I mean, just that immune system just as weak.
(08:05):
And we just started getting all these sorts of infections.
So the vaccine system is a way to sort of
lessen the possibility of having a severe infection. Had this conversation,
you stay with a patient of mine. Again, just remind
all the listeners and the patients, and they still get frustrated.
You know, I got this vaccine last year and I
(08:26):
still got infected. I still had to come to the
doctor's office. I don't like vaccines. It didn't work for me.
And I still have to remind my patients. And I
want to remind you that the way these vaccines are engineered,
like the COVID and the flu and pneumonia, is that
they keep it to a minimal disease. They lessen the
(08:48):
severity because really, at the end of the day, we
just we don't want to be hospitalized and we don't
want to have to take a bunch of meds or
potentially have to be on a ventilator or potentially not
make it or not survive. And again, as I mentioned
to you, the aging process is real your human systems.
(09:13):
Again that all the systems work together and coordinate it
in a coordinated fashion. And when you get older, that
aging process kicks in. All that stuff doesn't work as
well as a system. It becomes very dysfunctional, very chaotic.
And this is how you hear this story all the time,
where you know, Grandma was doing fine last week, she
(09:34):
was up and walking around, doing good, driving, playing outside,
and now she's in the hospital and the ventilator and
we don't know if she's going to make it. That's
why that happens, and it's hard for families to understand that,
but it's very easy for me to understand it because
I see this over and over again. I've seen it
(09:54):
over and over again over twenty years of treating patients
in the ICU. Is that aging process is one of
those things that's in the background and we might be
able to function okay, but when there's a time of crisis,
you know, like a covid infection or pneumonia infection, and
(10:17):
our bodies need to be strong and have endurance and
be able to tolerate stress, which again I call a
lot of these medical crisises medical trauma because that's a
lot of times what it is. It's just this very severe,
acute event where your body really needs to have some
(10:38):
tolerance and some endurance and it needs to be strong,
and unfortunately, getting older, it takes away from that and
the chances are if you get a severe traumatic medical event,
you know, you may not come out of that, or
it may leave you with there's some significant chronic issues
(11:03):
that you have to deal with, and that's why we're
doing our best to reduce that possibility. And vaccines is
the way to do that. Is it free of potential issues?
Speaker 2 (11:16):
Well?
Speaker 1 (11:16):
No, I mean nothing is in this world? Yes, sir,
I hear you.
Speaker 2 (11:24):
Hello, Hello, Hey, Bob, good morning. Hey. I'm not to
ask you. Hey, can you hear me?
Speaker 1 (11:31):
I got you go ahead.
Speaker 2 (11:33):
I'm got to ask you about salt substitute any clinical
data on a it's a fact.
Speaker 1 (11:43):
All right, you said, salt substitutes. Yeah, yeah, you know.
As you know, high pertension big problem in our country,
is a risk factor for cardio vascal disease. So over
the years we're trying to figure out how do we
were deduce the prevalence of hypertension and if you do
(12:03):
have higher pertension, how do we help you manage that.
So salt and take has been recognized as a risk
factor that can make high pertension worse or hard to control,
or even introduce the development of hypertension, and so there's
been a huge movement over the past many or twenty
(12:23):
thirty years, even before I became a physician, to limit
salt consumption, because I'm assuming this is probably before me,
A lot of times the average American would introduce salt
to their food when the food hit the table is
a way of seasoning or making the food taste a
(12:45):
certain ways. This is what they're accustomed to. They would
add salt and pepper when the food hit the table,
and that was recognized as a big risk factor for
the development of hypertension. So the food industry came up
with salt substitutes where it sort of tastes like salt,
(13:05):
but it's not really salt, almost like artificial sweeteners are today.
As it pertains to sweetness and sugar. A lot of
Americans consume a lot of sweet items. They eat sweet things,
they drink sweet things. But we know that consuming sugar
all the time is unhealthy, and so hey, we have
(13:26):
salt substitutes. So I'm sorry, we have sweetener substitutes or
sugar substitutes, which is similar to a salt substitute as well.
What is my understanding of that is that, yes, it
can be sort of a different alternative if you'd like
to salt your food. However, certainly I think at the
(13:48):
end of the day, most physicians would just recommend you
not use any salt substitutes, try not to put a
lot of salt in your food in terms of how
it's prepared, and certainly don't do it when you're and
it hits the table. So still unhealthy in my opinion
to include a lot of salt in your diet. And
(14:10):
we still want you to limit any sort of salt
or salt substitute as it pertains to that. So I
don't know that there's been a head to head study
that has compared if you do salt and then you
do salt substitutes, what are the outcomes. There might be
something out there like that, But from my standpoint, my
(14:33):
message to any patient of mine is, no matter what
sort of salt it is, real thing, old thing, artificial,
it's probably not healthy for you, and you should not
be engaging in that behavior if you want to be healthy.
That would be my message.
Speaker 2 (14:49):
I thought, Yeah, I thought you'd stay that. Yeah. Remember
back in the sixties in high school when we ate
them like candy, that's right, football, that's right. We damn
those things, you know.
Speaker 1 (15:02):
Yeah, absolutely. Yes, That's what's so cool about medical education
and medical science. We're always learning new things and understanding
that some things that we recommended probably not good for us,
and we change. So that's what that's why I like
the profession. We're always sort of changing and evolving and
maturing and figuring the things out. So yeah, try to
(15:24):
limit your salt intake. That would be the good thing,
all right, Bob. We appreciate that that question, just because
you know, I don't hear a whole lot about including
salt in the diet. You have understand that more of
us are eating out more often than not. We we
don't really cook a whole lot anymore, which we have
(15:45):
to get back to doing our own cooking, just because
when you eat out all the time, there's probably going
to be more salt and more sugar and more starch
in the food, and it's just better to prepare yourself.
Leonard from Houston, how can we help you?
Speaker 3 (16:05):
Do you answer dental type questions?
Speaker 1 (16:09):
I certainly can try. What's going on?
Speaker 3 (16:12):
I want to see my dentists two weeks ago and
she said that one of my teeth that has a
cap on it has become infected and she sent me
to a specialist and he confirmed that it's infected and
all that, and they're decide that it needs to be removed.
And I don't understand why they can't take off the cap,
treat the infection, and put the cat back on and
(16:34):
I don't have to lose the tooths.
Speaker 1 (16:38):
Well, Leonard, you're right. I'm not a dentist or our
dental surgeon, but I understand some sort of basic concepts
of infection, and a lot of times when a certain
structure of the body becomes infected, the bacteria have a
way of attaching themselves to that surface or that material,
(16:58):
and they sort of stay there, and you can treat
with antibiotics and it seems like the infection goes away,
but there is a lot of times still a presence
of the bacteria there such that if you continue to
use that same surface, or you put something on top
of the surface, the infection will come back. So a
(17:19):
lot of times, as it comes to artificial materials in
your mouth or anywhere else, a lot of times that
it all of it just has to be removed. You
just got to get rid of everything, because the bacteria
will attach itself to that surface and it'll figure out
a way to stay there and it won't go away,
and the only way to get rid of it is
just to remove whatever it's attached to and sort of
(17:41):
start over.
Speaker 3 (17:43):
The cap has been on there forty maybe fifty years.
It's so long a hell, I can't remember when it
was put on. It's never caused me any trouble. It
doesn't hurt. They tapped on it with a hammer or
whatever it was, didn't hurt. I just don't understand why
it has to be removed. I'm resistant to that concept.
Speaker 1 (18:03):
Yeah, you know, certainly, if something's been there for twenty
five years, is probably worn out and it's probably not
as functional as it used to be, and it's probably
new stuff out in the market, new material that the
dentists and the dental surgeons are using, and probably just
trying to get you up to speed with you know,
(18:24):
what's new and what's out there. And yes, it might
be cumbersome having all that done, But just as we
were mentioning about salt and salt substitutes, we learn new
things about all these materials and surgical techniques. And I
think the dentist is just doing its job and trying
(18:44):
to get you up to speed with you know, what's
the common understanding of how to deal with the current problems.
So I would probably if I were you, be a
little bit more open minded as it pertains to that,
and they're just trying to take care of you. You
can always get a second opinion from a different dentist.
Speaker 2 (19:03):
Uh.
Speaker 1 (19:04):
If if you're not quite happy with what you're listening to, you.
Speaker 3 (19:08):
Send me to a specialist, nindrogontist or something like that.
Speaker 1 (19:11):
I can't orthodontist, but.
Speaker 3 (19:14):
That guy said that it's infect and has to be improved,
and I don't. I still don't understand why I have
to take the tooth.
Speaker 1 (19:23):
Well, yeah, again, probably the tooth is the root of
the problem, if you will just our d Yeah, it
is our you know, our We don't talk a lot
about dental health and dental hygiene on this show, and
that's unfortunate, and we don't talk a lot about it
in the office, which is unfortunate. But your your teeth
(19:44):
and your gums, it's it's a really important part of
your health. And yes, as we get older, it's part
of the skin system. It does have a sort of
a degenitive wearing out process to it. And so we
lose our teeth, our teeth become more rotten, they crack,
they break, and again when something a lot of times
(20:04):
becomes infected, there's just it's just got to be everything's
got to be taken out, cleaned out so that the
tissues can heal. It's it's hard to leave infected material behind.
I think if it has an abscess, you know, get
you have to get what they call an incision and drainage,
(20:24):
or you have to get lanced. It's sort of that
same concept where the infection is so dense and it's
so widespread you have to just sort of cut it
open and just really wash it out. No different from
the mouth. And I think they've just learned over the
years that they can't do it halfway, like they got
to go all or none. And so that would probably
(20:46):
be my understanding of that. You know, the infection is
deep seated and they have to get all that infected
material out of there if they want this to get better.
Otherwise it'll fester and it will cause more damage to
the gums and the jaw and the bone and pain.
(21:06):
And sometimes the infection can get into your system and
we call that stepsis. So I think a lot of
times when it comes to mouth infects, you want to
get in there sooner rather than later. So that's sort
of my understanding of that. So I think if I
were you learn it, I'd go ahead and get it
in and just get it over with. Oh I'm sorry, Leonard,
(21:29):
sorry to hang up on you. I thought you were done.
Phone lines are open eight nine six kalv I won
one hundred and three three zero Kovy. I'll be back
in two minutes. All right, Welcome back to Dograly Meta.
(22:03):
Our phone lines are open eight nine to six kilva
at one hundred and three three zero KI. Happy Thanksgiving. Yeah,
that's why everybody's looking forar to the Thanksgiving Day where
we just kind of hang out and just gorge all
day and eat and watch football games. What a wonderful day.
And hopefully you and your family are getting ready for that,
(22:23):
you know when they were, you know, forget what the
doctor says. You know, you can have fun. But certainly, yeah,
dental hygiene. We don't talk a lot about that, but
it's important. It really is important, just because you can
get these sort of low grade infections in your mouth.
We call that ginge of vitis and just can't communicate
(22:47):
with your system in general, just because it is sort
of a low grade infection and the body is sort
of attached to your gums and your teeth. And certainly
there's been a lot a lot more growing awareness than
the medical community that yes, maybe that's something that we
need to start just mentioning to patients during your office visits.
(23:08):
You know, we have limited time a lot of times
in the office to get everything in, and the insurance
company is sort of understand this, and more and more
the insurance companies are sending representatives of the insurance company
to your house, normally medical staff, normally nurse practitioners to
(23:30):
come out and in the convenience of your home without
all the rush is to just kind of sit down
and chat about some highlighted issues or topics as it
pertains to your health, just because they know that when
you go to your doctor's visit, things might get overlooked
or missed or just run out of time and you
(23:53):
don't really get in that basic information that they're trying
to get in. It's just basic, basic stuff that really
can and make a difference in terms of your health
and meaning your blood pressure, your cholesterol, your mammogram, your
PSA level, colonoscopy, just really basic stuff that unfortunately, when
(24:15):
you go into your doctor's office, your healthcare profession's office,
you know you got about ten minutes or so. I
think most people will sort of know that it's pressurized time.
They only have so much time with the practitioner, and
people are starting to sort of prepare themselves for their visit.
You know, they'll write things down. I see that a lot.
(24:35):
They have sort of a list of what's on their
mind so that they don't forget. I think that's a
good habit. But trying to fit in the conversation about
your dental hygiene, I don't know that that's been talked
about too much or put on the radar of the
insurance companies, but it's certainly something that you should do,
(24:56):
is go and visit your dentist at least once a
year or every two year years, something along those lines.
Because again, as you know, every time you eat or drink,
your teeth and your gums are getting exposed to that
In a film, film can develop over the teeth and
the gums, and we call that plaque, just like the
plaque and the blood vessels. I don't know they're the
(25:17):
same composition, but it's the same term we use. That
build up or plaque develops on your teeth and your
gum line, and if it's not cleaned or scrubbed on
a regular basis, then it certainly can generate a low
grade of inflammation, which we call ginger vitis. A lot
of times, if you sort of look at your gum line,
(25:38):
it looks a bit more red or you can sort
of see some debris or discoloration along that line, which
a lot of times it's just plaque. Normally it's white.
And the thing that helps with that for the most
part is just flossing. Flossing every day, which I've learned
to do. Wasn't really introduced to flossing early on, but
(26:02):
certainly I do that now every single day. Just kind
of understand the process of plaque development better, and certainly
it helps keep your gum line and your teeth and
your gingeva as we call it, as healthy as possible. Certainly,
don't forget about brushing, but certainly these medical issues that
(26:23):
we talk about, diabetes, hypertension, high cholesterol, the metabolic syndrome
that a lot of patients get into because of the
types of foods and beverages that we're consuming. A lot
of times we'll start attacking the gum and the teeth
as well, and you can get gingibal infections. You all
sort of know those symptoms, just the pain and the
(26:45):
swelling that can happen in the gum line. And it's
hard to ignore it, right because you know, our faces
and our nose and our mouth has a lot of
nerve endings, and it's a hypersensitive area as opposed to
the hand or the back, not as embedded with nerve fibers,
(27:05):
and so when something is hurting there, it doesn't bother
us as much, but certainly in the face and the
nose and the mouth, man, when you get pain there,
it's very very irritating. And so if you've ever had
an infection there in that area, you know what I mean.
And a lot of times you have to start off
with antibiotics and get to your local dentist. So, yes,
(27:26):
if that's not something you do, that can be a
part of a healthy lifestyle, is to go to your
dentist on a regular basis and get a checkup and
make sure everything is okay. And you know, the structures
in there are very tight and a lot of times,
I say, when you get a deep seated infection or
an abscess, so you've had sort of this chronic low
(27:48):
grade gingible inflammation which we call ginger bvitis for a
long time, it kind of eats away at that structure,
you know, the gumline and the tooth and the root canal,
and sometimes the infection is so deep in the root that, yeah,
it has to be cleaned out. I think that's what
a root canal is. Not a dentist, but I think
(28:08):
that's what that is. Where they go in there, they
just have to clean everything out otherwise it'll sort of
keep getting deeper and deeper and more aggressive, and so
they just have to just make a standstill and get
all that junk out of there and sort of replace
it and repair it. And they have their ways of
(28:28):
doing that. But it's like with anything else with abscesses.
You know, we're getting pacemakers and defibrillators and hip joint replacements,
knee joint replacements, and it's no different with these man
made devices that are now embedded in our soft tissue,
whether it be a pain pump as well. When those
(28:51):
devices get infected. Unfortunately, the treatment of choice is a
lot of times those devices have to be taken out
just because when the bacteria gets on the surface of
this foreign material or this man made device, it just
doesn't want to go away. I mean, it attaches and
(29:13):
it stays there, and you can get hit with a
bunch of antibiotics, and while you're in the antibotics, everything
is hunky dory. But as soon as antibiotics goes away,
the bacteria, which again is hard to remove from that surface.
They normally generate what they call a biofilm, which is
almost as a layer of nutrition and support, if you will,
(29:37):
for the bacteria to survive on that surface. It's think
of it as a nest for the bacteria to live.
They generate this biofilm, and we haven't figured out a
way to eliminate this biofilm. Nonetheless, so once the antibiotics
go away, the biofilm is still there and the bacteria
start to flourish, and then you get the infection again.
(29:59):
So a lot of time a treatment for these pacemakers,
these the fribladers, the pain pumps, and unfortunately, yes, sometimes
these knee joints and shoulder joints, hip joints. Man, it's
got to be removed as well as back surgery. I
forgot about that. You know, maybe you had some spinal
stenosis and you had some herni diss it's pinching on
(30:22):
your nerve, and you underwent back surgery, and then you know,
a week later, two weeks later, a month later, you
start getting some drainage from that area. The wound opens up,
and then you go into the er or your your
surgeon and find out you have that back til infection
of the what we call hardware. And yeah, sometimes that
stuff has to be removed because otherwise it just will
(30:45):
not get better and it'll stay infected. It can really
sideline you for a whole year, you know, because a
lot of times you have to undergo a couple of surgeries,
you have to be hospitalized a bunch of times, you
need to be on antibiotics. You can't be at work
getting antibiotics, and it can really be a mess. Unfortunately,
(31:07):
when you get these deep seated soft tissue infections from
previous surgery are just spontaneously. As I talk to you
about the immune system, we do see patients that come
in just spontaneously with an infected shoulder or an infected joint,
or an infected heart valve, which we call endocarditis again
(31:29):
because that immune system is not as robust and maybe yeah,
you didn't get to your dentist quite on time. And
that bacteria that's in your mouth now you have gingerful inflammation.
And that bacteria gets in a bloodstream and it travels
around your body and it sort of finds this weak
area in your body, and certainly the heart valve if
(31:50):
you've had diabetes or high potensional high cholesterol, your smoke
over the years the surface of the heart valve. So
again just to wear and tear of the human body,
the surface will become very rough and more prone to
getting seated by bacteria that's floating around in your system.
Again from again bad ginger vitis. So you come in
(32:13):
with just don't feel well, fever, maybe achiness, and we
do a workup and you have blood I'm sorry, back
to in your bloodstream and then we find it's on
your heart valve and then there you go. You know,
that's a lot of times how that can sometimes happen
just spontaneously. No vaccines for that, but certainly you get
the point is one thing can lead to another leads
(32:34):
to another, and that's what doctors do all day is
try to discover those connections. Phone lines are open eight
nine to six kalv I one one hundred and three
three zero klv. I'll be back in two minutes. All right,
(33:08):
welcome back to TC with and madcour Phone lines are
opened eight nine six kvy I won one hundred and
three three zero kova. Happy Thanksgiving and hopefully you're having
a good day. Good Saturday morning, Bill from Beaumont. How
can we help you?
Speaker 4 (33:22):
Bill? I mean doc. Yeah, I have a swelling in
my left leg and I was wondering what I can
do to get it down. I was told I'm probably
got gut, but I don't know about that. But it's
sometimes the swelling gives me some discomfort, but most of
(33:47):
the time I can get by with it. But never
had it before.
Speaker 1 (33:53):
How long have you had it?
Speaker 4 (33:56):
Probably ten days, two weeks.
Speaker 1 (34:00):
Have you tried anything for it?
Speaker 4 (34:03):
No. I've tried to raise my leg up so the
fluid or blood whatever it is, would drain down, and
that did help to a certain extent.
Speaker 1 (34:15):
It's both sides, like left and right, or is just
one sided.
Speaker 4 (34:21):
It's my left leg.
Speaker 1 (34:26):
Okay, so it's more swollen than the right leg, yes, okay, Yeah,
A lot of times when it comes to the swelling,
which we call a edema, is a medical term for that.
A couple of things that we like to rule out.
One is what we call a DVT, which stands for
(34:47):
deep vein thrombosis. It's a blood cloth. That's the one
big thing we'd like to rule out, and that can
be easily done with an ultrasound and most minor care
and emergency departments have that availability. It's very easy to do.
And I would say if it's been there for two
(35:08):
weeks and it's not going away, that would be my
primary concern, and so we would recommend that you get
that checked out today because if there is a clot,
you need to be on blood dinners because if the
clot is not treated, then the clot gets bigger and
bigger and bigger, and it can then travel to your
(35:28):
lung and call and cause what we call a pulmonary
imbalis or PE for short. Yeah, So it can can
get pretty harry there for a while. So if you
do have swelling, something that is causing it and it
needs to be discovered, and so that would be my
top concern.
Speaker 4 (35:51):
Should I go through my cardiologists or my primary opposition.
Speaker 1 (35:57):
Whoever can get to you evaluated soon. This is what
I would do, whether it be your cardiologists or your primary.
Your primary should be able to handle that. But again,
if the swelling has been there for a couple of
weeks is not going anywhere, you can probably go to
a minor care or an er free standing Beaumady R
or Exceptional and they can take care of that for
(36:19):
you today, so you don't have to wait.
Speaker 4 (36:21):
Okay, Doc, thank you and appreciate your show.
Speaker 1 (36:28):
Absolutely. Bill, We'll appreciate your phone call, and we'll go
on our last breakfall lunch open eight and on Sixcalvy.
I want one hundred three three zero kalvy. I'll be
back all right, Welcome back to o'claviene Medical. Our phone
(36:50):
lines are open eight on six kalvy. I want one
hundred three three zero o ko v. I time for
li in at almost at the end of the show, I
want to thank all the call is for their calls
in questions. That's why we're here trying to help you
answer some of those lower extremity swelling or what we call
a dema or peripheral edema, that's another term for that
(37:13):
is extremely extremely common in this country. And yes, at
the top of the line, we want to be sure
you don't have a clot or throumbus. Remember, as we
get older, I keep talking about this, and I'm not
trying to make you sad, but just make you aware
that that process is real. As we get older, it
(37:36):
is real. Things are changing. Your system is working differently,
it's operating differently. And one of the things other than
the immune system declining, is the blood vessel system. And
the blood system itself is more prone to one clotting
and two bleeding both sides right, And when it clots,
(37:59):
it forms a blood boulder that basically prevents blood from
flowing forward, and that normally causes lack of blood flow
to a certain organ or a certain tissue bed, and
it causes what we call a schemia that's sort of
a metabolic result of lack of blood flow. And most
(38:23):
of the time patients know they have a schemia because
something stops working, they have pain. It looks different, but
with a deep vein thrombosis, it's in the venus system,
so because there are a lot of veins in the
venus system. If one clots off, the blood just sort
of goes around the clot initially, and so you might
(38:43):
have minimal symptoms. But as it gets bigger and bigger
and bigger, then more veins sort of get clotted off,
and your extremity normally gets more congested, and that's what
causes that swelling or dima because of blood can't flow
and you start getting backflow of blood and it will
(39:05):
cause some congestion of the tissue, which is what a
dema is. And so most people will see, hey, this
is swollen, and it just has to do with lack
of blood flow, and we normally pick that up on
an ultrasound can be done in most physicians' offices and
very easily at any sort of freestanding radiology business. We
(39:27):
have a lot more of those around where you don't
even have to have insurance, and the prices are very
reasonable to get basic testing done, blood tests, ultrasounds, Whether
pricing is really reasonable that you can get that done,
but certainly you want to know about that. It's not
something you want to put off. So if you have
that swelling to one side of your ankle or your leg.
(39:50):
You want to go ahead and get that venus ultrasound
and see what's going on with your circulation. Other than that, certainly,
infections can cause sort of this what we call unilateral swelling.
But when organ systems, certain organ systems don't work, like
the kidney system, the heart system, the liver system, they
(40:14):
can also cause congestion of blood flow and you start
getting the swelling of the lower extremity. Medications I forgot
about those can sometimes be the culprit. Some of our
blood pressure medicines and medicines we use for pain control.
Diabetes can sometimes generate a little swelling in one part
(40:37):
of your leg or the other, and certainly you have
to get to your primary care phcisian's office and get
that checked out and get some lab to see if
there's any problems with your kidney or your liver that
might be causing the swelling. But it could just be
what we call venus insufficiency, meaning just your veins and
(40:58):
your legs are just worn out out and don't work,
and that blood flow is sluggish and you start getting
that congestion and so you start getting swelling. But certainly
it's a symptom of something and it needs to be
figured out. So go get it figured out. Don't wait.
A lot of medical outlets have opened twenty four as
they seven. This weeks happen Thanksgiving, don't drink and drive,
(41:19):
have fun. We'll see you guys next week
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