Insomnia

Insomnia plagues millions of people.  After more than a decade in medicine,I have realized that the prescribed pharmaceutical sleep aids are just not good for people or their sleep.  For years I have been trying to identify sleep aids that do not disrupt the sleep-wake cycle, have little interaction with prescribed medication, and have no significant hang-over effects.  The agents listed below have been studied rather extensively, and may provide those insomniacs out there some degree of relief from their sleepless nights.

For awhile now, I have been recommending Valerian Root Extract.  The usual adult dose is 600-900 milligrams nightly.  Valerian Root has no known drug interactions, has not hang-over effect, and is more effective when taken on a nightly basis rather than an as-needed basis.  The only down side – it smells pretty bad – so plug your nose as you swallow your capsules and hopefully you’ll be sawing logs.

For older patient, a combination of melatonin 5 milligrams, magnesium 225 miiligrams and zinc 11.5 milligrams taken 1 our before bedtime for eight weeks seemed to improve sleep quality scores.  It is unknown whether this regimen is effective for younger adults.

Hope this helps!

Craig Endo, MD

 

Influenza

It is September and the influenza season is upon us once again.  Here is the United States the flu season usually extends from early fall to early spring, with the peak of activity occurring anytime from November through March.  The health impact of influenza on the population is significant.  Each year between 5 to 20% of the population get the flu, more than 200,000 people are hospitalized with flu-related complications, and deaths from flu-related causes average 23,000 a year with the very young and the very old most susceptible to serious complications.   Although the H1N1 flu pandemic reportedly ended in 2009, the H1N1 flu virus is circulating again this flu season, along with the other influenza viruses.

Just to dispel some common myths and misunderstanding surrounding influenza:

1)  The influenza vaccine CANNOT make you sick.  The influenza virus is killed in the flu shot, and weakened in the flu nasal spray vaccine.  With the nasal spray some people experience some headache, mild body aches, and/or runny nose, but recipients do not get influenza.

2)  The “Stomach Flu” is NOT the same as seasonal influenza.  The “Stomach Flu” is a popular term used for an intestinal infection, often with nausea, vomiting and diarrhea.  Influenza is primarily a respiratory disease with symptoms such as high fever, cough, runny nose, sore throat and severe body aches.  Nausea, vomiting and diarrhea can occur with influenza, but this is more commonly seen in children rather than adults.

Currently the BEST prevention we have for influenza is the vaccine.  The vaccine is indicated for people age 6 months and older and should be administered as soon as it is available.  Most people will receive the flu shot – and that includes pregnant women.  The influenza nasal spray is only for healthy people age 2 to 49 years old.

The only reasons to NOT get the influenza vaccine – if you were diagnosed with a rare condition called Guillan-Barre within 6 weeks of receiving an influenza vaccine, or if you have a SEVERE allergic reaction to chicken eggs or other components of the vaccines.

For more information on influenza, please visit www.flu.gov

If you have any comments please feel free to send them our way.  Also, if you are interested in a blog on a certain topic, please let me know.

Craig Endo, MD

 

What are the signs and symptoms of a stroke?

A stroke can generally occur in either of 2 ways.  First, there may be a blockage in a blood vessel that block blood flow to or from the brain.  Secondly, there can be a bleeding vessel in the brain.

In evaluating a person for a suspected stroke, use the F.A.S.T mnemonic.

Remember, stroke is an EMERGENCY.  Act F.A.S.T.  Know the signs and symptoms of stroke.

Face – Facial droop, Uneven smile

Arm – Arm numbness or weakness

Speech – Slurred speech, Difficulty Speaking or Understanding

Time – Call 911 immediately.  Ask to be transported to a nearby hospital / emergency room that is an  approved stroke center if possible.  Also, if would be ideal if the hospital had and interventional radiologist or neurosurgeon that could perform a procedure to treat the blocked or bleeding blood vessel.

 

What about newborn circumcision?

Circumcision is actually more of a cultural “American thing”. Aside from religious groups that practice newborn circumcision, not a whole lot of the global community circumcises there newborn son. In the United States, newborn boys are circumcised primarily because their fathers or brothers are circumcised. There is no definitive medical advantage to circumcision. In our practice only about 30% of the newborn boys are circumcised.
Now to the more technical stuff about circumcision…

Definition

Circumcision is the surgical removal of the foreskin
Description
The physician will numb the penis with local anesthesia before the procedure starts. The numbing
medicine will be injected at the base of the penis.
There are a variety of ways to perform a circumcision. Most commonly, the foreskin is pushed from the
head of the penis and clamped with a metal or plastic ring-like device.
If the ring is metal, the foreskin is cut off and the metal device is removed. The wound heals in 5-7 days.
If the ring is plastic, a piece of the suture is tied tightly around the foreskin. This pushes the tissue into a
groove in the plastic over the head of the penis. Within 5-7 days, the plastic covering the penis falls free,
leaving a completely healed circumcision.
The baby may be given a sweetened pacifier or lollipop during the procedure. Tylenol (acetaminophen) may
be given afterward.
Risks
• Risks related to circumcision:
• Bleeding
• Infection
• Redness around the surgery site
• Injury to the penis
• Poor cosmetic result. Scarring
Some research has suggested that uncircumcised male infants have an increased risk of certain conditions,
including:
• Cancer of the penis
• Certain sexually transmitted disease including HIV
• Infections of the penis
• Allergic reaction to iodine or lidocaine
• Philmosis (tightness of the foreskin that prevents it from retracting)
• Urinary tract infections
• the overall increased risk for these conditions is thought to be relatively small.

There you have it, parents, but the decision to circumcise or not is entirely yours.

Craig Endo, MD

 

What can I do for my cough and cold symptoms?

BE PATIENT! The common cold and most respiratory infections that cause sore throat, runny nose, and cough are the result of viral infections. Viral infections will not respond to antibiotics, and most upper respiratory viral infections can be expected to last 7-10 days. A viral bronchitis can linger for a few weeks. Usually it just takes a matter of time for the infection to run its course. However, if your symptoms progressively worsen, or go beyond the usual 7-10 days, you may want to make an appointment to see us.

There are a number of reportedly safe remedies that may help you symptoms. Echinacea and Pelargonium have been studied in Europe – most reliable studies of herbal and nutrition products come out of Germany. Echinacea may decrease the length of illness. Pelargonium in a few studies has been shown to be helpful with cough. Both can be taken in capsules.

Nasal saline irrigation solutions are generally safe to use and seem to improve symptoms of nasal congestion. There are several different brand available commercially.

Remember the old honey in tea home remedy for colds? Your mother or grandmother may have been on to something. In more recent studies, dark brown honey, and more specifically buckwheat honey seemed to be better at cough relief than any over the counter cough medication. When taken directly, one or two teaspoons every four to six hours, the dark brown honeys seemed to improve cough.

A word of caution. Honey can be associated with botulism toxicity. If you choose to use dark brown honey as a home remedy for cough, please DO NOT administer it to children younger than 2 years of age.

Hope these suggestions help!

Craig Endo, MD

 

Welcome to the Grace Medical Group blog site!

Hello and welcome to the brand new Grace Medical Group blog site!  We will be periodically posting current medical trends and information for you to review.  However, we REALLY want to hear about the things you are concerned about.  Please help us customize this site to meet the specific needs of the Grace Medical Group family of patients.  Happy blogging!

Craig Endo, MD