December 9, 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):
Welcome, Welcome, Welcome, Southeast Sex's Internet radio listeners. Welcome to
another edition of the Doctor Lavine Medical Hour. I'm your host,
Doctor Levine, coming to you live from the studios of
k LVI here in Beaumont, Texas, taking your phone calls,
answering questions about healthcare and medicine, hopefully to help you
(00:20):
try and stay alive as long as possible. I never
get tired of tired of listening to that song, as
that's everyone's goal, or should be your goal every single
day when you wake up, is how do I stay
alive longer and longer? And it can be complicated in
disorienting sometimes with all the information that we are exposed
(00:42):
to out there. My God, just everybody has an opinion,
including me. So thank you for joining me for another
edition of the show. Hopefully your Thanksgiving went well. I
was talking to my patients and it seems like for
the most part, it was a good day for most people.
Hanging out with the family and having their food and
(01:06):
beverage favorites and not trying to overdo it, but again
just having a good time and watching some ball games.
Seems like it was a good day for most people.
So hopefully it was good for you. And now we're
heading into the Christmas season. Everyone gets excited about that,
but tends to be more stressful in my opinion, you know,
(01:30):
with all of the focus on the gift and where
to get it and how many and who gets in
who doesn't, and just stressing out how am I going
to pay for it and they don't have them in
and times running out just adds another level our layer
of stress in my opinion, and tends to be a
(01:52):
little bit more anxiety provoking.
Speaker 2 (01:55):
Holiday and.
Speaker 1 (01:58):
The Turkey Day it's just more about and out and eating,
which we love doing in this country as.
Speaker 2 (02:04):
Well as I do.
Speaker 1 (02:05):
It's tough to avoid all those things that are bad
for you. But certainly if you want to stay out
and be healthy, you have to do that on a
more regular basis. Not that you have to do it
every day, but certainly I would say at least four
or five days out of the week. We want you
to try and do what's right for you.
Speaker 2 (02:27):
And then you.
Speaker 1 (02:28):
Know, couple that with some physical activity and again I
think the way it's advertised, man, who's going to do
all that sort of exercising on a regular basis. It's
tiring just to look at it, and just like with vaccines,
we have to make it more convenient and lower that threshold,
(02:49):
if you will, so that more people will enjoy themselves
engaging in that sort of physical activity and get some
benefits out of that. I can't remember just taking a
brisk walk or pedaling a bicycle, just getting a home treadmill,
which again they're more affordable, but nonetheless just putting on
(03:14):
some shoes and going outside and just taking a little
walk in the parking around your neighborhood and join the weather.
I mean, that is exercise. So there's been a lot
of people talk about exercising after they eat or taking
a little walk after they eat.
Speaker 2 (03:29):
It helps with the digestion.
Speaker 1 (03:32):
I do believe in that, and most people are not
looking far to exercising after they eat. They want to
sort of relax and take it easy. I certainly get
that too. It's been conversation about what time of day
is the best time of day to exercise, and I'll
be honest with you, I don't know that there's been
(03:53):
any head to head studies that have truly figured that out,
and based on my understanding and talking with thousands of patients,
a year. I really don't think it matters. I really
really don't. I think what matters is that some sort
(04:14):
of activity is performed again at least two or three
times a week. That's sort of what I have figured out.
We certainly have patients that exercise daily, and something wrong
with that if you want to do that, but is
it absolutely necessary for you to do that if you
want to get into your deep eighties or your deep nineties.
(04:37):
As most of my eighty ninety year old patients are
not really exercising every day. They might exercise once or
twice a week, but they're not necessarily doing it every day.
And it's certainly not high intensity. Again, we're talking about
just they just take a brisk walk, or they do
(04:58):
some exercising in the else, you know, light stuff, nothing heavy,
nothing strenuous, because certainly, if.
Speaker 2 (05:06):
You look at other athletes or other.
Speaker 1 (05:09):
Forms of exercising, the high intensity exercising that we see
and that's advertised on television and all the social outlets,
at some point tend to introduce injury to the muscular
skeletal system and sometimes even the cardiovascular system, you know,
(05:32):
So there is a balance with all that. And again
most the average person is really just not going to
tolerate exercising a high intensity. It's not fun for them,
it's sometimes difficult to do, it's time consuming. Number one,
because again most of our patients are busy with all
(05:56):
sorts of things throughout their life and they really don't
have time to commit to an hour to a day
of just exercising. And again, based on what I see
in my reading and just talking interviewing patients, which is
what I love about this position, is being able to
talk with patients and see what they're doing, and see
(06:19):
how they're living their lives, and again trying to provide
some direction, almost like a counselor, if you will, to
help them achieve some of their goals. But in doing so,
you sort of pick up these sort of common denominators
in terms of what's working out there, what's not working
out there. And again, high intensity exercising and based on
(06:42):
my understanding, is not absolutely necessary for you to perform
if you want.
Speaker 2 (06:48):
To have good cholesterol or good blood pressure, or.
Speaker 1 (06:52):
Live into your deep eighties or nineties. Just something that
I talk about a lot with my elderly payas who
are in their seventies or eighties. You know, there's unfortunately
a lot of dying and death around you when you
get to that age, whether it be your husband or
your wife, or other family members, friends you grew up with, acquaintances,
(07:17):
someone you.
Speaker 2 (07:18):
Know at church.
Speaker 1 (07:18):
There's just a lot of that conversation and a lot
of that exposure that starts to happen when you get
into your late sixties early seventies. And that's sort of
a big concern of a lot of my patients when
they get into that age, especially if they start developing
(07:39):
some new physical symptom that they didn't have before, it
really starts to generate some paranoia in terms of is
this the beginning of something that is going to be
detrimental to my health? And so you get a little
bit more paranoid at that age, and everyone is sort
(07:59):
of trying to figure out what do I need to
do so that that doesn't happen to me that which
is there's a thousand that's you know, that can happen, right,
But the main stuff that's happening, if you listen to
my show, you should know to answer to this is
cardiovascular disease is mainly what's happening. We're looking to start
(08:22):
a New Year in the next few weeks, and we're
always sort of take time to reassess our own health
and what we're doing and how can I better lower
my risk of that happening. When a friend or a
family or a coworker has some sort of physical experience,
(08:45):
it sort of freaks everyone out, and it sort of
certainly brings to your awareness that hey, I'm the same
age as that person, and that's certainly something that can
happen to me. Let me go to my doctor and
let me get some blood work, let me get some
extra Let's see what I can do to sort of
reduce my chances of that happening to me. And again,
(09:06):
if listens to my show, you should know it starts
with that diet. Starts with that diet. You know, I
do a lot of work in the hospital every single day,
and I talk to a lot of patients every single day,
and I look at their habits and I see what
they're eating, I see what they're drinking, And to me,
(09:28):
it certainly makes sense in terms of the relationships with
what you're putting in your mouth every day and the
risk of something happened, and I mean anything that could happen
to you diverticulitis, abscesses, and infections, which we talk about
heart attacks and strokes all the time, but my god,
(09:49):
we see a lot of infections in the hospital every
single day, and we talk a lot about immune system
and how it sort of declines as we get older,
and little ways we can increase our immune system to
offer that protection to us so that we're less likely
to get infection, which can be a variety of all
(10:13):
sorts of types of infections. We talk about vaccines, right,
that's one way to do that. We have Carolyn from Baytown.
How can we help you?
Speaker 3 (10:23):
Yes, could you speak a little bit about pneumonia and
right plural infusion. My husband at following hip surgery, came down.
It was doing great past everything out of his inpatient
rehab and home therapy and he comes down with pains
(10:44):
in his side. He went to er and cat stand
showed he had both of those and he's up now.
He followed up with his primary care doctor after the
er visit and when he finished his medications of him
on another medication. But she is he's older in pneumonia.
She gives it uh X ray chest X ray and
(11:07):
he's old in pneumonia. But he still has some of
that right. Well, it's on the right side of a
surly season. And did you just talk a little bit
about that. He was on different antibiotics, uh, the z
pact and uh uh moxy cave and just for the
(11:32):
mycene I believe, yes, he's just for a mysin two
hundred milligrams and uh like seven days and now he's
on level flocks and five hundred milligrams and then she's
got up tomorrow and we're just wondering if you could
talk a little bit about that.
Speaker 1 (11:49):
And you said he had a procedure.
Speaker 3 (11:55):
He broke his hip. Yeah, he felt fell in an
accident and uh hit a oak tree rope route, came
down across it and broke his hip. And then he
was doing great on that. He passed all all of
his things, just wonderful. He's doing this about everything he
wanted to and then he comes down with this pneumonia
(12:17):
in that other and it's just knocking for a loop,
you know. So we were just wondering if you could
talk a little bit how you would treat that or
what else we can expect. So he still has the
pain in his right side, and when he can't lay
on his right side. If he does, he just wakes
up in a severe pain there, so he sleeps propped up.
(12:40):
So you know, you'd have any information or anything about that.
We never even heard of that right pull effusion before.
Speaker 1 (12:48):
Yeah, it's medical terminology stuff, But Carolyn, it's super super
common having any sort of surgery in the hospital. For
your husband, it was a sort of a hip surgery repair.
The risk of what we call post operative infections as
(13:09):
well as hospital acquired infections as a term we use,
is extremely high, especially as you get older and the
more medical problems you have, your risk of getting an
infection after the surgery are super high, and everybody knows that,
and we're sort of on the lookout for that, and
we've tried to implement some things to reduce the possibility
(13:33):
of getting pneumonia, which pneumonia is a term we use
to describe lung infection, and lung infection can primarily be
from bacteria, which there are thousands, millions, trillions of bacteria
in the hospital, and when you get into the hospital again,
these bacteria can sort of you get exposed to these
(13:56):
bacteria and again, depending on your medical problems, the bacteria
can then cause an infection, primarily the lung infection, which
we call pneumonia, especially with after surgery. As anesthesia, you're
just laying in bed all day, your blood's not flowing,
you're not breathing the same, and pneumonia is super super
(14:17):
common anytime the lung gets infected, whether it be from
bacteria again, which is the most common type of lung infection,
but there's viruses as well, like covid and influenza. We
have diagnosed a lot of people in the hospital with
covid pneumonia that came in for different reasons and then
(14:40):
they subsequently get an infection there in the hospital and
we've diagnosed them with covid there in the hospital. So
it does happen flu as well. But what happens is
when the lung gets inflamed, it generates fluid that accumulates
in the space between the actual lung as well as
(15:02):
the rib cage.
Speaker 2 (15:03):
We call that the plural space, and.
Speaker 1 (15:08):
Fluid collects in there when you get an infection sometimes
and we call that an effusion, so plural effusion, and
it's basically fluid that collects in that space and it
can accompany any sort of lung infection and.
Speaker 4 (15:25):
It can be.
Speaker 1 (15:27):
Can cause some discomfort and pain. A lot of people
used to call it plurisy, and we sometimes still use
that term, but that sort of goes in line with
the lung infection and being in the hospital is to
develop this plural effusion. That plural effusion most of the
(15:48):
time does not have any sort of infection in It
is just fluid. But sometimes it can get infected and
it goes under a different name and we have to
sometimes perform another procedure to drain that infected fluid out
of the lung. Otherwise it acts like an abscess and
it can get bigger and bigger and cause more and
(16:09):
more problems. But most of the time the plural effusion
goes along with the infection of the lung. We call
that pneumonia, and we normally have various antibiotics that we
use to treat the pneumonia, and most patients do well,
which is what it sounds like happened to your husband.
(16:30):
But again, the recovery phase can be kind of long.
You know, it might take a month to fully recover
from a pneumonia that you get in the hospital, and
it might take a month or so for that plural
effusion to go away. The most important thing is to
continue or follow up with your doctors who are treating
the pneumonia to make sure he's getting better. He might
(16:52):
need a repeat chest X ray, he might need what
we call a cat scan again just to document the
resolution of the pneumonia and the plural effusion. So it's
Calvin is super super common. We see it a lot
every day. It's no one's fault. It's just one of
these things that happens when you have surgery and you're
(17:16):
sixty nine and you have heart disease and you get
a hip surgery, you have to go to the hospital.
It's just it's it's super common, but we're always looking
out for it, and we normally respond to it fairly
quickly and can get patients turned around and get them
out of the hospital. But it can sometimes sideline you
(17:38):
and lengthen your recovery phase. So sounds like everything's going
well with him though, and he's responding in you know,
everything is good. Does that answer your question?
Speaker 3 (17:52):
It surely does, and you're a summary assurance. He's eighty four,
but before this he fail he had no medication except
for cholesterol, said ya, medicine and very healthy and he'd
just returned from his two every day two mile walk
and everything, and this is just knocked him down because
(18:13):
he's been so healthy all this time and we're just
very worried about it. And he's given us some insurance.
Speaker 1 (18:18):
Now the thing, I like, yeah, the thing, I'm glad
you said that. I have this conversation a thousand times
every day when uh, a family member or a husband
and wife makes that statement. You know, hey, they were
they were fine two days ago, they were they were
they were driving a week ago and everything was fine,
(18:41):
and then now look at him. He can't even eat,
he can't even walk. I mean, what happened?
Speaker 3 (18:46):
I know?
Speaker 4 (18:47):
And yeah, you know it's it would be good.
Speaker 3 (18:51):
For him to get out and now are take it easy? Yeah?
Speaker 2 (18:57):
No, no, get up and.
Speaker 3 (18:59):
You're talking about you know and everything, get out and
walk and try to I know he's trying to take
a lot of deep breaths and stuff like that.
Speaker 1 (19:11):
Well, Carolyn, Yeah, if you listen to my show, I
try to help patients understand what qualifies as exercise. And
I think again, the way exercise is advertised, the average
person thinks that they have to run our sweat or
(19:31):
lifted a lot of heavy weight, or they have to
have a trainer, they got to join a gym. And
my point is that that is untrue that all your
husband has to do is get up and walk outside
for twenty minutes.
Speaker 2 (19:48):
That's it.
Speaker 3 (19:49):
You know, years and years ago he had an already
bypass in his leg and he was told walk and walk,
and he sits through his life, always kept that exercise going.
Like you say, he's been very very healthy, plays eighteen
or thirty six hours of golf. They walk, They don't
ride in a car right age. That's good. But you've
(20:11):
reassured us so much, and we appreciate you and we
love your show.
Speaker 1 (20:15):
Well, thank you that we appreciate that. Keep listening and
keep calling, all right, and we appreciate that phone call
brought up a lot of interesting topics. And uh, I'll
think about what I want to talk about on our
return to the second segment. Phone lines open eight nine
to sixth K three three. You're okay, I'll be back
(20:36):
in two minutes.
Speaker 4 (20:44):
Ye all right, allright, welcome back to talk to me
in medical.
Speaker 1 (21:01):
Our phone lines are open eight nine six kov I
one one hundred and three to three zero klv I
thanksgivings over. Christmas is coming. We love their Christmas season
and the music and the lights and just so exciting,
you know. And the weather is great today, it is.
I hope it doesn't get warm all that heat long
(21:24):
half mercy. It's so hot here. But I know, I
talk with patients who come from environments where it snows
all the time and it's like really wintery, and that
gets combersome too. You can't hardly move around, and we
freak out here inside of East Texas when we see
a little ice on the ground. We don't know what
to do. We shut down, we stay at home, we
(21:45):
don't do anything. But hopefully it stays cool because this
is such great weather. But yeah, it's a great time
of the year.
Speaker 2 (21:54):
And being in the.
Speaker 1 (21:55):
Hospital, yeah, it's kind of risky, you know. And as
is collar mentioned, you're going for one thing and you
leave with three things, you know. And I see it
every day in the hospital, and the idea that well,
you're doing fine today, but tomorrow you could be a
different person. And I see that every day as well,
(22:17):
and more so in again patients sixty five and above,
because what I was going to get into with the
recent caller is the fact that the aging process, and
you know, I sort of mention that all the time
because I want everyone to understand that that is a
real thing. When you get older, the aging process, It's real.
(22:43):
Your body does not work the same. I mean a
lot of It's almost like menopause for ladies, when ladies
go through menopause, when the estrogen levels fall and their
body reacts to that. Right, Some ladies breeze through it,
some don't, But there certainly is a metabolic physiological change
(23:05):
and how the body operates, and aging is no different.
And the essence, the essence, the true essence of aging,
right based on what I've seen, is the inability to
handle physiological and metabolic stress. It's it's you're you're you're
(23:25):
you're not as robust, it's you're not as strong, You're
more vulnerable, and your your ability to fight and tolerate
any sort of acute metabolic physiological stress is reduced just
the way the body functions. And that's why we talk
a lot about on this show. I try to do
(23:46):
it as much as possible in the office about how
can you reduce the chance of having to be hospitalized
on this patient that we were talking about in the
previous segment wasn't really is fault fail, which happens lot
as you get older, you lose your balance. You're still
trying to be active out there and just be involved, engaged,
(24:08):
taking care of your house, been out in the yard
cutting the grass. Injuries occur and falling is super common
as we get older. Again, aging process causes a decline
in the neurological muscular skeletal system, so your balance typically
is not as good. So when there's obstacles in the ground,
(24:31):
you miss a step, you're normally going to go down
pretty hard, pretty fast without being able to recover. And
depending on what you fall on and how you fall,
there might be some fractures. We see it fractured every
single day from falls, you know, falling on the porch
(24:53):
they have a pet and the pet gap between their
legs and they fell. They didn't see that some thing
on the ground, they tripped on it and fell at
the grocery store there at church. I mean every single
day we see these things. And because you're sixty five,
because you're seventy, because you're eighty, that's a big stress
(25:14):
on the body. It's trauma basically, and now you have
to go into the hospital to get it fixed. Well.
It's again because of this aging process and how it
affects the way your body functions. It just sometimes doesn't
go well in the hospital because your body is not
able to fight and not able to withstand everything that's
(25:37):
happening to you, and you can get complications. Not that
the diagnosis was wrong, not that the doctor didn't do this,
or the doctor didn't do that, or the nurse didn't
do the other thing. It's just that your bodies are
more vulnerable to these sort of complications and these problems
because you're not twenty, you're not thirty. That's when the
(25:58):
body's robust, it works, heals very well. That's another part
of getting older, is the inability to heal or does
it say reduction and healing. Healing takes longer. You know,
it's programmed into us. It's called aging, it's called getting older,
and we don't like it. I don't like it either.
Speaker 2 (26:17):
I'm older and.
Speaker 1 (26:18):
I feel the difference. And that's why you have to
invest more time into keeping the aging process at bay
as much as possible and doing what you can and
keep your body sharp and healthy and resilient, which this
patient was doing some daily walks, and again it's all
(26:39):
you got to do. You don't have to run this
have this big production of exercising, which again is normally
going to generate a bunch more obstacles, and most people
just like it's like, if I can't do all that,
then I'm just not going to do it right. We've
got to make it more convenient and help people understand
that exercising is and can be super convenient it but
(27:01):
impactful to your health.
Speaker 2 (27:03):
And sounds like this.
Speaker 1 (27:04):
Person was in that shape, good shape when they had
the hip fracture, the leg fraction, went to the hospital,
still got demonia, but the difference is, you know, they
responded very well to the medication, they got out of
the hospital successfully, and they're still going. We hear stories
(27:26):
all the time of someone having an injury, they felt
something happened, or they got hospitalized and never make it out.
And again a lot of times it's because again that
aging process is there. One thing leads to another leads
to another, just like this scenario. But I see a
lot of other scenarios, especially with surgery. Not that the
(27:50):
surgery went wrong, because let me tell you. They surgeons
and the whole.
Speaker 2 (27:55):
Surgical staff the hospital.
Speaker 1 (27:57):
They invest a lot of time into checks and balances
as it pertains to what happens before the surgery, doing
the surgery, after the surgery, again, trying to get you
out of the hospital as healthy and as problem free
as possible. We've gotten really good at it over the years.
(28:19):
Safety is a big issue in the hospital right now,
and most hospitals review all that stuff all the time, again,
trying to be as good as possible, as healthy as
I'm sorry, as safe as possible, and there's all these
things that we do, checks and balances every single day.
But even in that hypersensitive environment, patients still get pneumonia
(28:41):
after surgery. Periodically, it still happens. And if you come
into that equation unhealthy, meaning maybe you don't exercise, maybe
you're overweight, maybe you smoke, maybe your diabetes is not control,
your blood pressures out of control, you have heart disease,
you have lune disease, you have some other disease that
(29:03):
you're battling with.
Speaker 2 (29:05):
Your hospital course might be.
Speaker 1 (29:07):
More complicated because of that reason, because you're more vulnerable
because your body doesn't work as well as it needs
to to fend off this acute stress or medical trauma
as I call it. When you get pneumonia, that's medical
trauma basically, when you get infection in your lung and
(29:30):
it can affect your oxygen level and your carbon dioxide level,
and you know, just snowballs sometimes and we can't stop
the train or that, we can't stop the avalanche of
issues and it just sort of keeps going.
Speaker 2 (29:44):
We see it.
Speaker 1 (29:44):
Every day, and it's hard to explain that sometimes to
families who are not around that to doctors and nurses,
we see it every day.
Speaker 2 (29:54):
We're comfortable with it.
Speaker 1 (29:55):
We understand that that's just a part of it. Sometimes
we do everything we can to prevent that, but it
still happens because it's a part of that that we
can't prevent. And vaccines we talk about that all the
time here on this show, and you know it. When
I was in medical training, it wasn't really impressed upon
(30:17):
me about how important vaccines where I mean, I don't
even I don't even ever remember having many conversations about
vaccines when I was in medical training. But it's over
the past twenty years I've come to realize, what are
some things that really help keep you out of the
hospital and provide you with some layer of protection as
(30:39):
you're getting older and your immune system is getting worse
and you're now more vulnerable to any sort of infection
bladder infections, pneumonia, blood stream infections, skin infections, brain infections.
Speaker 2 (30:51):
Down on.
Speaker 1 (30:51):
I mean, just all this stuff can just happen. And
again it's programmed into us. But vaccines are one way
to do that. And again we want to keep reminding
you you can still get the infection. I keep hearing
that every I mean, I'm still surprised every week, you know,
somebody comes in line. I'm not getting that vaccine. I
got it last year, and you know I got an infection.
(31:14):
You know, I guess I still got sick. I know,
but you didn't get hospitalized. Though you're here talking to me.
You're doing fine. And that's the whole idea behind the
vaccine is your body is ready to fight. That's what
it does. It puts you in a position where your
body is ready to defend itself. If you get an
(31:38):
invasion from a certain organism normally bacteria or viruses, your
body is ready to go. And instead of you getting
super sick and having to be on a breathing machine
and the ICU with kidney and liver failure. You were
able to stay at home, maybe go to a doctor
(31:59):
and get some tablets and maybe some talentol for headache
and fever, maybe a little under the weather for a
few days. But you stayed at home and nothing much
happened other than you got a little ill. I mean,
that's how the vaccines work, and that's what you truly
(32:19):
have to understand that you can still get the infection,
but it's supposed to keep it to a minimum. And
in my experience on my side talking to patients, it
does make a huge difference for those who are vaccinated
and those who are not. I mean, I clearly see
it with my own eyes because of all the different
(32:40):
scenarios I see talking to patients listening to what they do,
it's a big deal. Those who are vaccinated and those
who are not vaccinated, they tend to get sicker more frequently,
and their sickness is normally more severe, ending them up
in the hospital, exposing their body to that medical trauma
(33:03):
and increasing the opportunity for them not to get out
of there, because again, you can't really stop the aging process.
You can kind of slow it down and mitigate it,
but it's coming and you want to try and do
what you can to be ready to go in case
(33:24):
something happens, which as we get older nine times ten,
something's going to happen, and you want to be ready.
And those who are ready, they do certain things every day, right,
and most of them are getting those vaccines, most of
them have their weight down, most of them are doing
some sort of exercising, they're not smoking, they're not drinking now,
(33:45):
they're doing all the basic stuff and they can get
into their eighties and nineties.
Speaker 2 (33:49):
I see it. It's very clear.
Speaker 1 (33:51):
Phone lines are open eight nine to six scalva. I
went one hundred and three to three zero kyov. I'll
be back in two minutes and welcome back to docahed
(34:11):
medical phone line. Phone Yeah, I phone eight nine six
K one hundred three three zero klv I, welcome back.
Speaker 4 (34:18):
It's doctor Lavine, Doc Lavine Medical.
Speaker 1 (34:21):
How we're talking about being in the hospital getting older
gos not a good topic, but sometimes you have to
talk about it and it brings up interesting point about
just infections that can happen there in the hospital. And
just so you guys know, man all major American hospitals
(34:41):
are working feverishly to keep that place as safe and
sound as possible. They work every day at it, and
it's a lot of moving parts in the hospital, a
lot of practitioners, and it's complicated. It's super complicated. Based
on when I first got out, Man, it's multi layered
now and I don't see that slowing down.
Speaker 2 (35:02):
But it's all to get.
Speaker 1 (35:03):
You in and out of there as safely as possible,
as clean as possible, with minimal complications. And we have
implemented a lot of systems to improve the opportunity that
you will get out of there as safe and sound
with the right diagnosis, on the right medications, with the
right follow up, et cetera, et cetera. And just to
(35:27):
let you know that's that's going on all the time,
even though you're in there for pneumonia or you had
a heart attack, or you just had dizziness and you
got dehydrated, you had some nause and vomiting. I mean,
they are there trying to figure out how can we
make this better and better? But things still can happen
there in the hospital. Infections is one of them. It's
(35:50):
a big what we call hospital acquired issue pneumonia, and
that's an infection of the lung. And it's a lot
of time because most of the time when you're sick,
you just.
Speaker 2 (36:02):
Land in bed.
Speaker 1 (36:04):
You're not moving. And when you land bed, and I've
seen this with my own eyes, a lot of bad
things happen.
Speaker 2 (36:10):
You just land in.
Speaker 1 (36:11):
Bed day after day after day, and you're not standing up,
you're not sitting up. Your body functions totally different. I
mean you can try it at home. It's painful almost
to lay in bed all day. You don't feel good.
But as soon as you get up and kind of
(36:32):
walk around move haf feel better. Yeah, energy is back
versus just landing in bed all day. But unfortunately, when
we get into hospital, man, maybe we just were nauseated,
we're dizzy, we have a headache, we're just weak, we
have pain somewhere. We just we don't want to move,
you know, moving makes it worse, and so you end
up just laying in bed day after day. And with
(36:55):
my experience, man, you get a lot of complications, and
pneumonia is one of them. Just because the blood ain't
flowing like it should and you ain't breathing like you should,
and you can start getting plural effusions. One reason is
because we're normally giving you ivy or intravenious fluids, and
a lot of times we're a little bit heavy handed
(37:16):
with that, and so you start to accumulate fluid in
certain body areas. And if you've ever had a loved
one in the hospital, you know what I mean. Those
arms and those hands start getting puffy, and the abdomen area,
which we call the torso, starts getting puffy or a demitis,
and you can press down on it and it just
(37:37):
makes that indention in the skin. It's just all from
fluid and the blood not flowing. Because of what happens
to the human body when it's sick and it's ill,
it works totally differently. And pneumonia is a unfortunately a
issue that comes up frequently in the hospital. If you
get in there for various reasons, a surgery, maybe you've
(38:01):
had a heart attack and you're just hanging out for
a couple of days and you just laying in bed. Man,
we see it. Phone lines are open. We're gonna gonna
last break. Be back in two minutes, all right, Welcome
(38:21):
back to SOCA the Medical Hour. Michael from beaumint real fast.
How can we help you?
Speaker 5 (38:26):
Yeah, sir, I want to know if you have any
information that you could share about low dose pretozone or
steroid long term use for chronic inflammation, and I'll hang up.
Listen to your anthrom regular.
Speaker 1 (38:41):
Sir, all right, we appreciate that phone called Michael. Low
dose pregtizone for chronic inflammation.
Speaker 2 (38:47):
I love steroids.
Speaker 1 (38:49):
Not a lot of people do. I've learned to love
steroids and I use them a lot. But there is
a price to pay for using steroids every single day,
because we sometimes get in a situation where patients have inflammation,
perfect example, just degenitive joint disease, osteothritis, joints herd, back hurt,
(39:11):
and neck hurts. What do we normally reach for? We
reach for stuff like motri and advil, leave talanol, and
for the most part, that's it. That's all we do.
But what if you have heart disease, kidney disease, ulcras
in your stomach, you known blood thinners. We don't like
you to use that stuff, but you're hurting, you're inflamed. Steroids. Yes,
(39:33):
I do it all the time. Low dose pretnizona millogram
two milligrams as needed. I use it as my anti
inflammatory was I taught that no, But I've learned that
over the years as a doctor. Is there a risk, Yes,
there is no zero risk anything. Anytime you start putting
tablets in your mouth, there is a risk. I normally
just talk with my patients about that. These are the risks,
(39:57):
and most people accept it, and in my experience, most
people do okay. They do okay with a low dose
steroid periodically to help them fight inflammation. They do okay.
Can it increase risk of osti process yes, cataracts yes,
high sugar yes, high blood pressure yes, weight gain yes,
(40:20):
it can do all that stuff.
Speaker 2 (40:22):
But you keep the dose to.
Speaker 1 (40:24):
A minimum like a milligram, which is really low dose,
but you get that anti inflammatory impact, meaning your back
doesn't hurt as much, your hands don't hurt as much.
I use it, but I have a conversation with my patient,
explain the risks and benefits, and we have a shared
decision making with that. Not that I'm going to that
(40:45):
first line. That's really like last resort sort of thing.
Speaker 2 (40:48):
But I do use it.
Speaker 1 (40:49):
And there are people who have diseases that require steroids
and they do sometimes have those adverse reaction issues with it,
but we have that conversation and we work around it.
And sometimes you have to do these things in patients
depending on the condition. Things are not perfect, so you're
just trying to help patients. But I do use steroids.
I love them, but you got to be careful just
(41:11):
like antibiotics, they can harm as well. And just have
the conversation with your patient. Anyway, I appreciate all the
phone calls, good topics. Hopefully you're having a wonderful day
to day. Remember don't drink a drive, eat a vegetable.
Speaker 2 (41:23):
We'll see you next week. Take care,
Welcome, Welcome, Welcome, Southeast Sex's Internet radio listeners. Welcome to
another edition of the Doctor Lavine Medical Hour. I'm your host,
Doctor Levine, coming to you live from the studios of
k LVI here in Beaumont, Texas, taking your phone calls,
answering questions about healthcare and medicine, hopefully to help you
(00:20):
try and stay alive as long as possible. I never
get tired of tired of listening to that song, as
that's everyone's goal, or should be your goal every single
day when you wake up, is how do I stay
alive longer and longer? And it can be complicated in
disorienting sometimes with all the information that we are exposed
(00:42):
to out there. My God, just everybody has an opinion,
including me. So thank you for joining me for another
edition of the show. Hopefully your Thanksgiving went well. I
was talking to my patients and it seems like for
the most part, it was a good day for most people.
Hanging out with the family and having their food and
(01:06):
beverage favorites and not trying to overdo it, but again
just having a good time and watching some ball games.
Seems like it was a good day for most people.
So hopefully it was good for you. And now we're
heading into the Christmas season. Everyone gets excited about that,
but tends to be more stressful in my opinion, you know,
(01:30):
with all of the focus on the gift and where
to get it and how many and who gets in
who doesn't, and just stressing out how am I going
to pay for it and they don't have them in
and times running out just adds another level our layer
of stress in my opinion, and tends to be a
(01:52):
little bit more anxiety provoking.
Speaker 2 (01:55):
Holiday and.
Speaker 1 (01:58):
The Turkey Day it's just more about and out and eating,
which we love doing in this country as.
Speaker 2 (02:04):
Well as I do.
Speaker 1 (02:05):
It's tough to avoid all those things that are bad
for you. But certainly if you want to stay out
and be healthy, you have to do that on a
more regular basis. Not that you have to do it
every day, but certainly I would say at least four
or five days out of the week. We want you
to try and do what's right for you.
Speaker 2 (02:27):
And then you.
Speaker 1 (02:28):
Know, couple that with some physical activity and again I
think the way it's advertised, man, who's going to do
all that sort of exercising on a regular basis. It's
tiring just to look at it, and just like with vaccines,
we have to make it more convenient and lower that threshold,
(02:49):
if you will, so that more people will enjoy themselves
engaging in that sort of physical activity and get some
benefits out of that. I can't remember just taking a
brisk walk or pedaling a bicycle, just getting a home treadmill,
which again they're more affordable, but nonetheless just putting on
(03:14):
some shoes and going outside and just taking a little
walk in the parking around your neighborhood and join the weather.
I mean, that is exercise. So there's been a lot
of people talk about exercising after they eat or taking
a little walk after they eat.
Speaker 2 (03:29):
It helps with the digestion.
Speaker 1 (03:32):
I do believe in that, and most people are not
looking far to exercising after they eat. They want to
sort of relax and take it easy. I certainly get
that too. It's been conversation about what time of day
is the best time of day to exercise, and I'll
be honest with you, I don't know that there's been
(03:53):
any head to head studies that have truly figured that out,
and based on my understanding and talking with thousands of patients,
a year. I really don't think it matters. I really
really don't. I think what matters is that some sort
(04:14):
of activity is performed again at least two or three
times a week. That's sort of what I have figured out.
We certainly have patients that exercise daily, and something wrong
with that if you want to do that, but is
it absolutely necessary for you to do that if you
want to get into your deep eighties or your deep nineties.
(04:37):
As most of my eighty ninety year old patients are
not really exercising every day. They might exercise once or
twice a week, but they're not necessarily doing it every day.
And it's certainly not high intensity. Again, we're talking about
just they just take a brisk walk, or they do
(04:58):
some exercising in the else, you know, light stuff, nothing heavy,
nothing strenuous, because certainly, if.
Speaker 2 (05:06):
You look at other athletes or other.
Speaker 1 (05:09):
Forms of exercising, the high intensity exercising that we see
and that's advertised on television and all the social outlets,
at some point tend to introduce injury to the muscular
skeletal system and sometimes even the cardiovascular system, you know,
(05:32):
So there is a balance with all that. And again
most the average person is really just not going to
tolerate exercising a high intensity. It's not fun for them,
it's sometimes difficult to do, it's time consuming. Number one,
because again most of our patients are busy with all
(05:56):
sorts of things throughout their life and they really don't
have time to commit to an hour to a day
of just exercising. And again, based on what I see
in my reading and just talking interviewing patients, which is
what I love about this position, is being able to
talk with patients and see what they're doing, and see
(06:19):
how they're living their lives, and again trying to provide
some direction, almost like a counselor, if you will, to
help them achieve some of their goals. But in doing so,
you sort of pick up these sort of common denominators
in terms of what's working out there, what's not working
out there. And again, high intensity exercising and based on
(06:42):
my understanding, is not absolutely necessary for you to perform
if you want.
Speaker 2 (06:48):
To have good cholesterol or good blood pressure, or.
Speaker 1 (06:52):
Live into your deep eighties or nineties. Just something that
I talk about a lot with my elderly payas who
are in their seventies or eighties. You know, there's unfortunately
a lot of dying and death around you when you
get to that age, whether it be your husband or
your wife, or other family members, friends you grew up with, acquaintances,
(07:17):
someone you.
Speaker 2 (07:18):
Know at church.
Speaker 1 (07:18):
There's just a lot of that conversation and a lot
of that exposure that starts to happen when you get
into your late sixties early seventies. And that's sort of
a big concern of a lot of my patients when
they get into that age, especially if they start developing
(07:39):
some new physical symptom that they didn't have before, it
really starts to generate some paranoia in terms of is
this the beginning of something that is going to be
detrimental to my health? And so you get a little
bit more paranoid at that age, and everyone is sort
(07:59):
of trying to figure out what do I need to
do so that that doesn't happen to me that which
is there's a thousand that's you know, that can happen, right,
But the main stuff that's happening, if you listen to
my show, you should know to answer to this is
cardiovascular disease is mainly what's happening. We're looking to start
(08:22):
a New Year in the next few weeks, and we're
always sort of take time to reassess our own health
and what we're doing and how can I better lower
my risk of that happening. When a friend or a
family or a coworker has some sort of physical experience,
(08:45):
it sort of freaks everyone out, and it sort of
certainly brings to your awareness that hey, I'm the same
age as that person, and that's certainly something that can
happen to me. Let me go to my doctor and
let me get some blood work, let me get some
extra Let's see what I can do to sort of
reduce my chances of that happening to me. And again,
(09:06):
if listens to my show, you should know it starts
with that diet. Starts with that diet. You know, I
do a lot of work in the hospital every single day,
and I talk to a lot of patients every single day,
and I look at their habits and I see what
they're eating, I see what they're drinking, And to me,
(09:28):
it certainly makes sense in terms of the relationships with
what you're putting in your mouth every day and the
risk of something happened, and I mean anything that could happen
to you diverticulitis, abscesses, and infections, which we talk about
heart attacks and strokes all the time, but my god,
(09:49):
we see a lot of infections in the hospital every
single day, and we talk a lot about immune system
and how it sort of declines as we get older,
and little ways we can increase our immune system to
offer that protection to us so that we're less likely
to get infection, which can be a variety of all
(10:13):
sorts of types of infections. We talk about vaccines, right,
that's one way to do that. We have Carolyn from Baytown.
How can we help you?
Speaker 3 (10:23):
Yes, could you speak a little bit about pneumonia and
right plural infusion. My husband at following hip surgery, came down.
It was doing great past everything out of his inpatient
rehab and home therapy and he comes down with pains
(10:44):
in his side. He went to er and cat stand
showed he had both of those and he's up now.
He followed up with his primary care doctor after the
er visit and when he finished his medications of him
on another medication. But she is he's older in pneumonia.
She gives it uh X ray chest X ray and
(11:07):
he's old in pneumonia. But he still has some of
that right. Well, it's on the right side of a
surly season. And did you just talk a little bit
about that. He was on different antibiotics, uh, the z
pact and uh uh moxy cave and just for the
(11:32):
mycene I believe, yes, he's just for a mysin two
hundred milligrams and uh like seven days and now he's
on level flocks and five hundred milligrams and then she's
got up tomorrow and we're just wondering if you could
talk a little bit about that.
Speaker 1 (11:49):
And you said he had a procedure.
Speaker 3 (11:55):
He broke his hip. Yeah, he felt fell in an
accident and uh hit a oak tree rope route, came
down across it and broke his hip. And then he
was doing great on that. He passed all all of
his things, just wonderful. He's doing this about everything he
wanted to and then he comes down with this pneumonia
(12:17):
in that other and it's just knocking for a loop,
you know. So we were just wondering if you could
talk a little bit how you would treat that or
what else we can expect. So he still has the
pain in his right side, and when he can't lay
on his right side. If he does, he just wakes
up in a severe pain there, so he sleeps propped up.
(12:40):
So you know, you'd have any information or anything about that.
We never even heard of that right pull effusion before.
Speaker 1 (12:48):
Yeah, it's medical terminology stuff, But Carolyn, it's super super
common having any sort of surgery in the hospital. For
your husband, it was a sort of a hip surgery repair.
The risk of what we call post operative infections as
(13:09):
well as hospital acquired infections as a term we use,
is extremely high, especially as you get older and the
more medical problems you have, your risk of getting an
infection after the surgery are super high, and everybody knows that,
and we're sort of on the lookout for that, and
we've tried to implement some things to reduce the possibility
(13:33):
of getting pneumonia, which pneumonia is a term we use
to describe lung infection, and lung infection can primarily be
from bacteria, which there are thousands, millions, trillions of bacteria
in the hospital, and when you get into the hospital again,
these bacteria can sort of you get exposed to these
(13:56):
bacteria and again, depending on your medical problems, the bacteria
can then cause an infection, primarily the lung infection, which
we call pneumonia, especially with after surgery. As anesthesia, you're
just laying in bed all day, your blood's not flowing,
you're not breathing the same, and pneumonia is super super
(14:17):
common anytime the lung gets infected, whether it be from
bacteria again, which is the most common type of lung infection,
but there's viruses as well, like covid and influenza. We
have diagnosed a lot of people in the hospital with
covid pneumonia that came in for different reasons and then
(14:40):
they subsequently get an infection there in the hospital and
we've diagnosed them with covid there in the hospital. So
it does happen flu as well. But what happens is
when the lung gets inflamed, it generates fluid that accumulates
in the space between the actual lung as well as
(15:02):
the rib cage.
Speaker 2 (15:03):
We call that the plural space, and.
Speaker 1 (15:08):
Fluid collects in there when you get an infection sometimes
and we call that an effusion, so plural effusion, and
it's basically fluid that collects in that space and it
can accompany any sort of lung infection and.
Speaker 4 (15:25):
It can be.
Speaker 1 (15:27):
Can cause some discomfort and pain. A lot of people
used to call it plurisy, and we sometimes still use
that term, but that sort of goes in line with
the lung infection and being in the hospital is to
develop this plural effusion. That plural effusion most of the
(15:48):
time does not have any sort of infection in It
is just fluid. But sometimes it can get infected and
it goes under a different name and we have to
sometimes perform another procedure to drain that infected fluid out
of the lung. Otherwise it acts like an abscess and
it can get bigger and bigger and cause more and
(16:09):
more problems. But most of the time the plural effusion
goes along with the infection of the lung. We call
that pneumonia, and we normally have various antibiotics that we
use to treat the pneumonia, and most patients do well,
which is what it sounds like happened to your husband.
(16:30):
But again, the recovery phase can be kind of long.
You know, it might take a month to fully recover
from a pneumonia that you get in the hospital, and
it might take a month or so for that plural
effusion to go away. The most important thing is to
continue or follow up with your doctors who are treating
the pneumonia to make sure he's getting better. He might
(16:52):
need a repeat chest X ray, he might need what
we call a cat scan again just to document the
resolution of the pneumonia and the plural effusion. So it's
Calvin is super super common. We see it a lot
every day. It's no one's fault. It's just one of
these things that happens when you have surgery and you're
(17:16):
sixty nine and you have heart disease and you get
a hip surgery, you have to go to the hospital.
It's just it's it's super common, but we're always looking
out for it, and we normally respond to it fairly
quickly and can get patients turned around and get them
out of the hospital. But it can sometimes sideline you
(17:38):
and lengthen your recovery phase. So sounds like everything's going
well with him though, and he's responding in you know,
everything is good. Does that answer your question?
Speaker 3 (17:52):
It surely does, and you're a summary assurance. He's eighty four,
but before this he fail he had no medication except
for cholesterol, said ya, medicine and very healthy and he'd
just returned from his two every day two mile walk
and everything, and this is just knocked him down because
(18:13):
he's been so healthy all this time and we're just
very worried about it. And he's given us some insurance.
Speaker 1 (18:18):
Now the thing, I like, yeah, the thing, I'm glad
you said that. I have this conversation a thousand times
every day when uh, a family member or a husband
and wife makes that statement. You know, hey, they were
they were fine two days ago, they were they were
they were driving a week ago and everything was fine,
(18:41):
and then now look at him. He can't even eat,
he can't even walk. I mean, what happened?
Speaker 3 (18:46):
I know?
Speaker 4 (18:47):
And yeah, you know it's it would be good.
Speaker 3 (18:51):
For him to get out and now are take it easy? Yeah?
Speaker 2 (18:57):
No, no, get up and.
Speaker 3 (18:59):
You're talking about you know and everything, get out and
walk and try to I know he's trying to take
a lot of deep breaths and stuff like that.
Speaker 1 (19:11):
Well, Carolyn, Yeah, if you listen to my show, I
try to help patients understand what qualifies as exercise. And
I think again, the way exercise is advertised, the average
person thinks that they have to run our sweat or
(19:31):
lifted a lot of heavy weight, or they have to
have a trainer, they got to join a gym. And
my point is that that is untrue that all your
husband has to do is get up and walk outside
for twenty minutes.
Speaker 2 (19:48):
That's it.
Speaker 3 (19:49):
You know, years and years ago he had an already
bypass in his leg and he was told walk and walk,
and he sits through his life, always kept that exercise going.
Like you say, he's been very very healthy, plays eighteen
or thirty six hours of golf. They walk, They don't
ride in a car right age. That's good. But you've
(20:11):
reassured us so much, and we appreciate you and we
love your show.
Speaker 1 (20:15):
Well, thank you that we appreciate that. Keep listening and
keep calling, all right, and we appreciate that phone call
brought up a lot of interesting topics. And uh, I'll
think about what I want to talk about on our
return to the second segment. Phone lines open eight nine
to sixth K three three. You're okay, I'll be back
(20:36):
in two minutes.
Speaker 4 (20:44):
Ye all right, allright, welcome back to talk to me
in medical.
Speaker 1 (21:01):
Our phone lines are open eight nine six kov I
one one hundred and three to three zero klv I
thanksgivings over. Christmas is coming. We love their Christmas season
and the music and the lights and just so exciting,
you know. And the weather is great today, it is.
I hope it doesn't get warm all that heat long
(21:24):
half mercy. It's so hot here. But I know, I
talk with patients who come from environments where it snows
all the time and it's like really wintery, and that
gets combersome too. You can't hardly move around, and we
freak out here inside of East Texas when we see
a little ice on the ground. We don't know what
to do. We shut down, we stay at home, we
(21:45):
don't do anything. But hopefully it stays cool because this
is such great weather. But yeah, it's a great time
of the year.
Speaker 2 (21:54):
And being in the.
Speaker 1 (21:55):
Hospital, yeah, it's kind of risky, you know. And as
is collar mentioned, you're going for one thing and you
leave with three things, you know. And I see it
every day in the hospital, and the idea that well,
you're doing fine today, but tomorrow you could be a
different person. And I see that every day as well,
(22:17):
and more so in again patients sixty five and above,
because what I was going to get into with the
recent caller is the fact that the aging process, and
you know, I sort of mention that all the time
because I want everyone to understand that that is a
real thing. When you get older, the aging process, It's real.
(22:43):
Your body does not work the same. I mean a
lot of It's almost like menopause for ladies, when ladies
go through menopause, when the estrogen levels fall and their
body reacts to that. Right, Some ladies breeze through it,
some don't, But there certainly is a metabolic physiological change
(23:05):
and how the body operates, and aging is no different.
And the essence, the essence, the true essence of aging,
right based on what I've seen, is the inability to
handle physiological and metabolic stress. It's it's you're you're you're
(23:25):
you're not as robust, it's you're not as strong, You're
more vulnerable, and your your ability to fight and tolerate
any sort of acute metabolic physiological stress is reduced just
the way the body functions. And that's why we talk
a lot about on this show. I try to do
(23:46):
it as much as possible in the office about how
can you reduce the chance of having to be hospitalized
on this patient that we were talking about in the
previous segment wasn't really is fault fail, which happens lot
as you get older, you lose your balance. You're still
trying to be active out there and just be involved, engaged,
(24:08):
taking care of your house, been out in the yard
cutting the grass. Injuries occur and falling is super common
as we get older. Again, aging process causes a decline
in the neurological muscular skeletal system, so your balance typically
is not as good. So when there's obstacles in the ground,
(24:31):
you miss a step, you're normally going to go down
pretty hard, pretty fast without being able to recover. And
depending on what you fall on and how you fall,
there might be some fractures. We see it fractured every
single day from falls, you know, falling on the porch
(24:53):
they have a pet and the pet gap between their
legs and they fell. They didn't see that some thing
on the ground, they tripped on it and fell at
the grocery store there at church. I mean every single
day we see these things. And because you're sixty five,
because you're seventy, because you're eighty, that's a big stress
(25:14):
on the body. It's trauma basically, and now you have
to go into the hospital to get it fixed. Well.
It's again because of this aging process and how it
affects the way your body functions. It just sometimes doesn't
go well in the hospital because your body is not
able to fight and not able to withstand everything that's
(25:37):
happening to you, and you can get complications. Not that
the diagnosis was wrong, not that the doctor didn't do this,
or the doctor didn't do that, or the nurse didn't
do the other thing. It's just that your bodies are
more vulnerable to these sort of complications and these problems
because you're not twenty, you're not thirty. That's when the
(25:58):
body's robust, it works, heals very well. That's another part
of getting older, is the inability to heal or does
it say reduction and healing. Healing takes longer. You know,
it's programmed into us. It's called aging, it's called getting older,
and we don't like it. I don't like it either.
Speaker 2 (26:17):
I'm older and.
Speaker 1 (26:18):
I feel the difference. And that's why you have to
invest more time into keeping the aging process at bay
as much as possible and doing what you can and
keep your body sharp and healthy and resilient, which this
patient was doing some daily walks, and again it's all
(26:39):
you got to do. You don't have to run this
have this big production of exercising, which again is normally
going to generate a bunch more obstacles, and most people
just like it's like, if I can't do all that,
then I'm just not going to do it right. We've
got to make it more convenient and help people understand
that exercising is and can be super convenient it but
(27:01):
impactful to your health.
Speaker 2 (27:03):
And sounds like this.
Speaker 1 (27:04):
Person was in that shape, good shape when they had
the hip fracture, the leg fraction, went to the hospital,
still got demonia, but the difference is, you know, they
responded very well to the medication, they got out of
the hospital successfully, and they're still going. We hear stories
(27:26):
all the time of someone having an injury, they felt
something happened, or they got hospitalized and never make it out.
And again a lot of times it's because again that
aging process is there. One thing leads to another leads
to another, just like this scenario. But I see a
lot of other scenarios, especially with surgery. Not that the
(27:50):
surgery went wrong, because let me tell you. They surgeons
and the whole.
Speaker 2 (27:55):
Surgical staff the hospital.
Speaker 1 (27:57):
They invest a lot of time into checks and balances
as it pertains to what happens before the surgery, doing
the surgery, after the surgery, again, trying to get you
out of the hospital as healthy and as problem free
as possible. We've gotten really good at it over the years.
(28:19):
Safety is a big issue in the hospital right now,
and most hospitals review all that stuff all the time, again,
trying to be as good as possible, as healthy as
I'm sorry, as safe as possible, and there's all these
things that we do, checks and balances every single day.
But even in that hypersensitive environment, patients still get pneumonia
(28:41):
after surgery. Periodically, it still happens. And if you come
into that equation unhealthy, meaning maybe you don't exercise, maybe
you're overweight, maybe you smoke, maybe your diabetes is not control,
your blood pressures out of control, you have heart disease,
you have lune disease, you have some other disease that
(29:03):
you're battling with.
Speaker 2 (29:05):
Your hospital course might be.
Speaker 1 (29:07):
More complicated because of that reason, because you're more vulnerable
because your body doesn't work as well as it needs
to to fend off this acute stress or medical trauma
as I call it. When you get pneumonia, that's medical
trauma basically, when you get infection in your lung and
(29:30):
it can affect your oxygen level and your carbon dioxide level,
and you know, just snowballs sometimes and we can't stop
the train or that, we can't stop the avalanche of
issues and it just sort of keeps going.
Speaker 2 (29:44):
We see it.
Speaker 1 (29:44):
Every day, and it's hard to explain that sometimes to
families who are not around that to doctors and nurses,
we see it every day.
Speaker 2 (29:54):
We're comfortable with it.
Speaker 1 (29:55):
We understand that that's just a part of it. Sometimes
we do everything we can to prevent that, but it
still happens because it's a part of that that we
can't prevent. And vaccines we talk about that all the
time here on this show, and you know it. When
I was in medical training, it wasn't really impressed upon
(30:17):
me about how important vaccines where I mean, I don't
even I don't even ever remember having many conversations about
vaccines when I was in medical training. But it's over
the past twenty years I've come to realize, what are
some things that really help keep you out of the
hospital and provide you with some layer of protection as
(30:39):
you're getting older and your immune system is getting worse
and you're now more vulnerable to any sort of infection
bladder infections, pneumonia, blood stream infections, skin infections, brain infections.
Speaker 2 (30:51):
Down on.
Speaker 1 (30:51):
I mean, just all this stuff can just happen. And
again it's programmed into us. But vaccines are one way
to do that. And again we want to keep reminding
you you can still get the infection. I keep hearing
that every I mean, I'm still surprised every week, you know,
somebody comes in line. I'm not getting that vaccine. I
got it last year, and you know I got an infection.
(31:14):
You know, I guess I still got sick. I know,
but you didn't get hospitalized. Though you're here talking to me.
You're doing fine. And that's the whole idea behind the
vaccine is your body is ready to fight. That's what
it does. It puts you in a position where your
body is ready to defend itself. If you get an
(31:38):
invasion from a certain organism normally bacteria or viruses, your
body is ready to go. And instead of you getting
super sick and having to be on a breathing machine
and the ICU with kidney and liver failure. You were
able to stay at home, maybe go to a doctor
(31:59):
and get some tablets and maybe some talentol for headache
and fever, maybe a little under the weather for a
few days. But you stayed at home and nothing much
happened other than you got a little ill. I mean,
that's how the vaccines work, and that's what you truly
(32:19):
have to understand that you can still get the infection,
but it's supposed to keep it to a minimum. And
in my experience on my side talking to patients, it
does make a huge difference for those who are vaccinated
and those who are not. I mean, I clearly see
it with my own eyes because of all the different
(32:40):
scenarios I see talking to patients listening to what they do,
it's a big deal. Those who are vaccinated and those
who are not vaccinated, they tend to get sicker more frequently,
and their sickness is normally more severe, ending them up
in the hospital, exposing their body to that medical trauma
(33:03):
and increasing the opportunity for them not to get out
of there, because again, you can't really stop the aging process.
You can kind of slow it down and mitigate it,
but it's coming and you want to try and do
what you can to be ready to go in case
(33:24):
something happens, which as we get older nine times ten,
something's going to happen, and you want to be ready.
And those who are ready, they do certain things every day, right,
and most of them are getting those vaccines, most of
them have their weight down, most of them are doing
some sort of exercising, they're not smoking, they're not drinking now,
(33:45):
they're doing all the basic stuff and they can get
into their eighties and nineties.
Speaker 2 (33:49):
I see it. It's very clear.
Speaker 1 (33:51):
Phone lines are open eight nine to six scalva. I
went one hundred and three to three zero kyov. I'll
be back in two minutes and welcome back to docahed
(34:11):
medical phone line. Phone Yeah, I phone eight nine six
K one hundred three three zero klv I, welcome back.
Speaker 4 (34:18):
It's doctor Lavine, Doc Lavine Medical.
Speaker 1 (34:21):
How we're talking about being in the hospital getting older
gos not a good topic, but sometimes you have to
talk about it and it brings up interesting point about
just infections that can happen there in the hospital. And
just so you guys know, man all major American hospitals
(34:41):
are working feverishly to keep that place as safe and
sound as possible. They work every day at it, and
it's a lot of moving parts in the hospital, a
lot of practitioners, and it's complicated. It's super complicated. Based
on when I first got out, Man, it's multi layered
now and I don't see that slowing down.
Speaker 2 (35:02):
But it's all to get.
Speaker 1 (35:03):
You in and out of there as safely as possible,
as clean as possible, with minimal complications. And we have
implemented a lot of systems to improve the opportunity that
you will get out of there as safe and sound
with the right diagnosis, on the right medications, with the
right follow up, et cetera, et cetera. And just to
(35:27):
let you know that's that's going on all the time,
even though you're in there for pneumonia or you had
a heart attack, or you just had dizziness and you
got dehydrated, you had some nause and vomiting. I mean,
they are there trying to figure out how can we
make this better and better? But things still can happen
there in the hospital. Infections is one of them. It's
(35:50):
a big what we call hospital acquired issue pneumonia, and
that's an infection of the lung. And it's a lot
of time because most of the time when you're sick,
you just.
Speaker 2 (36:02):
Land in bed.
Speaker 1 (36:04):
You're not moving. And when you land bed, and I've
seen this with my own eyes, a lot of bad
things happen.
Speaker 2 (36:10):
You just land in.
Speaker 1 (36:11):
Bed day after day after day, and you're not standing up,
you're not sitting up. Your body functions totally different. I
mean you can try it at home. It's painful almost
to lay in bed all day. You don't feel good.
But as soon as you get up and kind of
(36:32):
walk around move haf feel better. Yeah, energy is back
versus just landing in bed all day. But unfortunately, when
we get into hospital, man, maybe we just were nauseated,
we're dizzy, we have a headache, we're just weak, we
have pain somewhere. We just we don't want to move,
you know, moving makes it worse, and so you end
up just laying in bed day after day. And with
(36:55):
my experience, man, you get a lot of complications, and
pneumonia is one of them. Just because the blood ain't
flowing like it should and you ain't breathing like you should,
and you can start getting plural effusions. One reason is
because we're normally giving you ivy or intravenious fluids, and
a lot of times we're a little bit heavy handed
(37:16):
with that, and so you start to accumulate fluid in
certain body areas. And if you've ever had a loved
one in the hospital, you know what I mean. Those
arms and those hands start getting puffy, and the abdomen area,
which we call the torso, starts getting puffy or a demitis,
and you can press down on it and it just
(37:37):
makes that indention in the skin. It's just all from
fluid and the blood not flowing. Because of what happens
to the human body when it's sick and it's ill,
it works totally differently. And pneumonia is a unfortunately a
issue that comes up frequently in the hospital. If you
get in there for various reasons, a surgery, maybe you've
(38:01):
had a heart attack and you're just hanging out for
a couple of days and you just laying in bed. Man,
we see it. Phone lines are open. We're gonna gonna
last break. Be back in two minutes, all right, Welcome
(38:21):
back to SOCA the Medical Hour. Michael from beaumint real fast.
How can we help you?
Speaker 5 (38:26):
Yeah, sir, I want to know if you have any
information that you could share about low dose pretozone or
steroid long term use for chronic inflammation, and I'll hang up.
Listen to your anthrom regular.
Speaker 1 (38:41):
Sir, all right, we appreciate that phone called Michael. Low
dose pregtizone for chronic inflammation.
Speaker 2 (38:47):
I love steroids.
Speaker 1 (38:49):
Not a lot of people do. I've learned to love
steroids and I use them a lot. But there is
a price to pay for using steroids every single day,
because we sometimes get in a situation where patients have inflammation,
perfect example, just degenitive joint disease, osteothritis, joints herd, back hurt,
(39:11):
and neck hurts. What do we normally reach for? We
reach for stuff like motri and advil, leave talanol, and
for the most part, that's it. That's all we do.
But what if you have heart disease, kidney disease, ulcras
in your stomach, you known blood thinners. We don't like
you to use that stuff, but you're hurting, you're inflamed. Steroids. Yes,
(39:33):
I do it all the time. Low dose pretnizona millogram
two milligrams as needed. I use it as my anti
inflammatory was I taught that no, But I've learned that
over the years as a doctor. Is there a risk, Yes,
there is no zero risk anything. Anytime you start putting
tablets in your mouth, there is a risk. I normally
just talk with my patients about that. These are the risks,
(39:57):
and most people accept it, and in my experience, most
people do okay. They do okay with a low dose
steroid periodically to help them fight inflammation. They do okay.
Can it increase risk of osti process yes, cataracts yes,
high sugar yes, high blood pressure yes, weight gain yes,
(40:20):
it can do all that stuff.
Speaker 2 (40:22):
But you keep the dose to.
Speaker 1 (40:24):
A minimum like a milligram, which is really low dose,
but you get that anti inflammatory impact, meaning your back
doesn't hurt as much, your hands don't hurt as much.
I use it, but I have a conversation with my patient,
explain the risks and benefits, and we have a shared
decision making with that. Not that I'm going to that
(40:45):
first line. That's really like last resort sort of thing.
Speaker 2 (40:48):
But I do use it.
Speaker 1 (40:49):
And there are people who have diseases that require steroids
and they do sometimes have those adverse reaction issues with it,
but we have that conversation and we work around it.
And sometimes you have to do these things in patients
depending on the condition. Things are not perfect, so you're
just trying to help patients. But I do use steroids.
I love them, but you got to be careful just
(41:11):
like antibiotics, they can harm as well. And just have
the conversation with your patient. Anyway, I appreciate all the
phone calls, good topics. Hopefully you're having a wonderful day
to day. Remember don't drink a drive, eat a vegetable.
Speaker 2 (41:23):
We'll see you next week. Take care,
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