Ask The Doctor

Everything you wanted to know about Defibrillators: Part 1

2015-11-24T16:21:00.001-08:00

Everything you wanted to know about Defibrillators: Part 1

Defibrillators are also referred to as Automated External defibrillators (AED). These portable medical devices can generate an instant electrical shocks to the heart when its rhythm becomes perilously irregular or fast. Once the shock is delivered , the heart rate and rhythm can be immediately restored back to normal. Time is of essence because any delay in administering the shock can lead to permanent damage to the heart, and result in death. When the heart rhythm is not restored within 4-6 minutes, the prognosis is poor.

The sooner the heart rhythm is restored, the better are the chances of survival without any permanent organ damage. Each minute is critical and the chances of survival dim with each passing minute.

Defibrillators can be used with in the home, business setting or in a hospital setting. Today defibrillators are carried by police, ambulance crews, and are also available on planes, sport arenas, shopping malls, casino and hotels.

Automatic external defibrillators have been approved by the FDA. The only automatic defibrillator available without a prescription for home use is the Phillips Heart Start Home defibrillator. The HeartStart defibrillator can be used on children as young as 8 years in age.

There are many types of AED on the market.

The Cardiac Science device delivers life saving defibrillation therapy without having to push any buttons. The Welch Allyn and HeartStart Onsite Defibrillators are fully automatic and can even guide you through the CPR process. The automatic defibrillators also have a voice program which explains what needs to be done during a cardiac arrest.

Once the pads have been applied, the AED automatically analyses the individual's heart rhythm and determines if a shock is required. If this is so, the machine will either sound an alarm or may announce the need. The user must stand back and press a button to deliver the charge. The process can be repeated 2-3 times until the 911 emergency crew comes over.

All AEDs are simple to use with minimal training. The current defibrillators will even make a determination as to whether a shock should be administered. The defibrillators come with a manual and instructions on how to use them. Accessories to the defibrillators include pads, batteries, paddles and battery chargers and these come with the AED.

Weight loss with green tea

2015-08-26T05:01:00.001-07:00

Can I lose weight with green tea?

For the one millionth time, green tea or any other tea beverage is nothing more than a scam. If you think you are going to lose weight by just drinking green tea, you are sadly mistaken. There is nothing in green tea that can induce weight loss or curb your appetite. The green tea maniacs, like the vitamin D maniacs, have now gotten everyone to buy their bogus products for only reason- money. Green tea is a great social beverage but it has no magical powers. You can drink it, shower in it, have an enema with it – you still will not lose weight. Every single clinical study has shown that tea beverages for weight loss are useless- you may as well drink your own piss.

The green tea business is a multi-billion dollar scam with lots of false promises to desperate people who want to lose weight. The only way you can lose weight with green tea is by just drinking this beverage and not eating anything- and that is not realistic. If you want to lose weight, stop buying tea beverages as the only thing you will get is disappointment. To lose weight, eat less and walk more- free and no hassles.

Gabapentin for fibromyalgia

2015-08-26T04:49:00.002-07:00

Does gabapentin work in patients with fibromyalgia?

Wow, this is a difficult subject. Patients with fibromyalgia are complex and have many comorbid disorders including a terrible personality; they are always blaming everyone else for their medical problems and are extremely negative. They are some of the most difficult patients to treat and I avoid them-chiefly cause I am a surgeon and have little interest in non-surgical disorders.

However I have post graduate training in pharmacology and know a fair bit about medications. As far as gabapentin is concerned, it is a widely used drug to treat neuropathy. It does work in some diabetics and in patients with shingles and post herpetic neuralgia. As far as fibromyalgia is concerned, the drug does not always work. The evidence to support its use in fibromyalgia is weak. However, some patients with fibromyalgia have found the drug useful. The only way to know if gabapentin will work in fibromyalgia is to try it out for at least 2-3 weeks. Beware the drug has many adverse effects including weight gain, sedation and swelling of the extremities.

Topiramate for diabetic neuropathy?

2015-08-26T04:47:00.003-07:00

Does topiramate relieve pain in neuropathy?

Topiramate is an anticonvulsant which is also used to treat migraine. It is sometimes prescribed by doctors to treat peripheral neuropathy. Unfortunately evidence to support its use in diabetic neuropathy is weak. At the moment, the drug should be considered experimental as there is little or no evidence to indicate that it works in diabetic neuropathy. However, it is a great drug for people with migraine.

Vitamin D for pain relief

2015-08-16T04:50:00.002-07:00

Can vitamin D be used to treat pain?

The vitamin D maniacs get up every morning and starting blogging about the virtues of vitamin D. In the last year alone, these maniacs have published millions of blogs indicating that Vitamin D can cure almost every disorder under the sun.

Now to the facts- the majority of anecdotal reports on vitamin D are published by morons who do not have grade 2 education. These blogs are often written on social media sites like Facebook, which has now become the encyclopedia of medicine- most of the advice is bogus and borders on stupidity.

Second vitamin D is classified as a fat soluble vitamin and NOT as an analgesic (pain killer). Thirdly, vitamin D is never used in any healthcare setting to treat pain.

Over the past few years, there have been some reports indicating that vitamin D may be used to treat chronic painful disorders in adults. Vitamin D is produced in the skin after exposure to sunlight and perhaps it may module pain sensation.

So does vitamin D relieve pain?

Countless studies have been done assessing the benefits of oral and topical vitamin D in people with all types of pain syndromes. The results indicate that you may as well drink your PISS. It does jack shit.

There is not a single study which has unequivocally shown that vitamin D can relieve pain. The few studies which show that vitamin D can relieve pain have been done by doctors who were paid by the manufacturers and these data have not been reproducible by independent investigators.

So if you have weak or thinning of bones, you can take vitamin D but if you have pain, then you will have to try something else. Vitamin D is not a pain killer and is not classified as an analgesic. You can use vitamin D as a pill, lotion, potion, enema, inhaler, suppository or shower with it- it will provide no pain relief – all it will do is bring you more disappointment for being a sucker.

Does TENS work for pain relief?

2015-08-16T04:43:00.003-07:00

Does TENS provide pain relief?

There is so much stuff written on TENS that it is difficult to know what is true or false. The people who make this device have tons of great reviews about the various TENS machines and their benefits. On the other hand, consumers with pain who use TENS indicate that the device does not always work and the pain relief is not sustained.

In fact, the majority of reviews on TENS by people with pain indicate that the device sucks. In one recent large review, the overall feeling is that TENS is just another gimmick designed to scam patients. The pain relief in most cases is minimal and you can get the same relief by massaging the area with a dildo.

So if you have the money, save it and use it for something else. If you do not have money to buy a TENS machine, do not worry, you are not missing out on anything. Remember medicine is a business and the name of the game is to sucker desperate patients with a lot of crappy devices. If people who had pain stopped going to doctors, more than 60% of doctors would become unemployed.

Results after bariatric surgery

2015-08-16T04:40:00.001-07:00

Are the results after bariatric surgery permanent?

Weight loss surgery when done right can lead to dramatic weight loss in some lucky individuals. However, to ensure that the weight loss is sustained, you will need to change your lifestyle. There are countless reports of people who lost significant weight after bariatric surgery and regained it within 2-5 years.

If you want the results of weight loss surgery to last, you will need to change your lifestyle dramatically. That means never ever going back to your poor eating habits and exercising regularly. Individuals who do not change their life style quickly regain the weight. So even if it is your birthday, avoid the cheesecake

Methotrexate for my osteoarthritis

2015-08-16T04:39:00.000-07:00

Can methotrexate be used to treat osteoarthritis?

First you have to understand that there is no cure for OA. Methotrexate is the drug of choice for rheumatic arthritis. However, there are some physicians who also use methotrexate to treat pain in patients with osteoarthritis. Several small studies have shown that methotrexate can provide mild pain relief in patients with OA. However, before you jump in line to get your methotrexate prescription; be well informed of the drug's adverse effects, which are quite unpleasant. These adverse effects range from nausea, vomiting, general fatigue to severe liver disease.

Methotrexate treatment for OA should be considered experimental until we have more data. At the moment the drug's adverse effects override any benefit. So I would caution you against using it. It remains the drug of choice for rheumatoid arthritis, which is a completely different disease from osteoarthritis.

Corticosteroid injection for my osteoarthritis

2015-08-16T04:36:00.002-07:00

I have osteoarthritis. Can a shot of steroids help me exercise more?

Doctors have been scamming patients with injections of steroids for decades. In the majority of cases, these steroids injections do not do anything. There are many studies showing that if you do not have inflammation in the joint, the injection of a corticosteroid is useless and a complete waste of money. If you have osteoarthritis, corticosteroid injections will not help. There is no randomized study that has shown benefit from corticosteroid injections in people with chronic osteoarthritis. There are anecdotal reports of mild decrease in pain, but then there are just as many reports which indicate no pain relief.

So my advice is stay away from doctors who offer these injections as they are only concerned about making money and care little about your welfare.

Corticosteroid injections are heavily abused by doctors for one reason- they bring in a lot of money but do crap for the patient.

Magnesium for high blood pressure

2015-05-21T14:59:00.001-07:00

Can magnesium supplements help lower my blood pressure?

Recently the public has gone crazy over magnesium. Consumers have been buying kilograms of magnesium powder to treat a variety of health disorders. Many people have jars of magnesium powder underneath their bed and they religiously take it every night before time. Analysis of clinical studies reveal that there is no clinical evidence that magnesium can lower blood pressure. A few patients did have lowering of diastolic blood pressure, but the effects are inconsistent and not sustained.

If I were you, I would stick to the Meds prescribed by your doctor. High blood pressure is a silent disorder but if you do not treat it, you will end up with a heart attack or a stroke. All the magnesium you need is readily available from your diet. You will be hard pressed to find people with magensium deficiency on planet earth. People who promote magnesium are charlatans who have little knowledge about medical physiology but excel at talking from their backside.

Omega 3 fatty acids for bipolar disorder

2015-05-21T14:56:00.000-07:00

Can omega 3 fatty acids improve symptoms of bipolar disorder?
Omega 3 fatty acids are hyped to treat many medical disorders but in reality they do diddy squat. After almost half a century of hearing about omega fatty acids, there is no drastic reduction in any illness or cancer- it is just another supplement that is hyped up by ignorant people to scam even more ignorant people.

The little evidence we have indicates that omega 3 fatty acids are useless for BPD- you can get the same benefit by drinking your urine or if you prefer, a donkey’s urine.

Latex or non latex condoms?

2015-05-21T14:53:00.004-07:00

Is a latex condom better than a non-latex condom as a contraceptive?

The non-latex condoms are used by people who have allergy to latex. There are very few studies on the different condoms and their efficacy as contraceptives. But some non-latex condoms like eZ do not prevent pregnancy as well as latex condoms. In general, the non-latex condoms tend to break more often than latex condoms. Overall, most partners prefer non latex condoms.
My feeling is that non-latex condoms are overpriced and are only useful for people who are allergic to latex.

Dry mouth treatment

2015-05-21T14:52:00.001-07:00

Is there any non-drug treatment that can help improve dry mouth?
No, there is none. Studies have shown that acupuncture, lasers, tooth brushing, mild electrical stimulation or other stimulation techniques all suck. Complete waste of money. Only morons and stupid people go for these therapies.
If you have dry mouth from sjogren syndrome, the best advice is to see a rheumatologist. There is a medication called cevimeline. There are anecdotal reports that it can help some patients with dry mouth. It is also prohibitively expensive and does not work in everyone. Best advice is drink a lot of water, use lozenges and take good dental care if you got dry mouth.

Can Primrose Oil Lower my blood sugars?

2015-05-21T14:50:00.001-07:00

In the last two decades many individuals have started taking primrose oil for a number of medical ailments. Some just take the primrose oil for routine prophylaxis for a better life style. Others take primrose oil because their friends take it and then there are others who take primrose oil because they are hoping for a miracle.
Evening primrose oil (EPO) is known to contain an omega-6 essential fatty acid which is believed to be the active ingredient. There has been a lot of research on Primrose oil. The majority of research has been sponsored by companies who manufacture the product. The substance has been widely used in Europe for decades for the treatment of arthritis, constipation, fibromyalgia, premenstrual syndrome, headaches, nausea, eczema, atopic dermatitis, hypertension, diabetes, weight loss, etc. There are many reports from diabetic individuals that daily intake of primrose oil can lower blood sugars. However, high-quality evidence for its use in most conditions is still lacking. In addition, primrose oil does not lower blood sugar in everyone and its effects are unreliable and inconsistent.

Conditions where there is some clinical evidence about the benefits of Primrose oil include skin disorders like eczema, chronic fatigue syndrome, herpetic infections and diabetes. But one has to remember that all the evidence is anecdotal. There are no randomized clinical studies which have evaluated the benefits of primrose oil and no one has any idea what the other ingredients in Primrose oil are.
With regard to diabetes, the few available reports do indicate the blood glucose levels decrease after regular intake of the chemical. Other individuals with long standing diabetic neuropathy have also claimed that the pain and tingling that occurs with diabetes disappears with oral intake of primrose oil.

Unfortunately, such isolated reports are often made by vendors of the product and have little scientific validity.
At the moment, Primrose oil is not a substitute for the standard treatment of diabetes. It may be used as an adjunct to insulin and the other oral hypoglycemic drugs. Side effects of Primrose oil include headaches, abdominal pain, diarrhea and occasionally drop in blood pressure. There is not enough information to recommend the safe use of evening primrose oil during pregnancy or breastfeeding.

Laser to remove tattoos

2015-05-07T15:57:00.000-07:00

Can a laser remove all tattoos? part 1
There is laser mania going on all over the USA. Every tom, dick and harry is using the laser to treat a variety of skin conditions. When in doubt, use the laser appears to be the motto. First, for anyone who is thinking of undergoing laser, just read the news. Every single day there is a report about a complication from a laser. Lasers have caused severe burns and disfiguration of many individuals. Lasers are not harmless instruments and in the hands of people who do not know the mouth from the backside, you are in for big trouble. The majority of people who use lasers are clueless and have never completed any type of formal laser training. If you walk into a spa, the people who use lasers only know how to switch the device on and off- and they only learnt that aspect after watching someone else. Then these same people go and start their own spa business acting like laser experts. So beware whom you go to.

Gastric sleeve and GERD

2015-05-07T15:56:00.000-07:00

I had a gastric sleeve procedure done a few months ago and now have developed moderate amount of burning in my chest whenever I lie down. Is this normal?
No, what you have is most likely reflux. During gastric sleeve resection, the surgeon makes a tube out of the stomach and sometimes the anatomical valve at the bottom of the swallowing tube is either deformed or altered as a result of the surgery. Many patients are now reporting symptoms of reflux after gastric sleeve resection. This is a direct result of surgery. The backwash of acid from the stomach into the swallowing tube can cause a burning sensation in the throat and chest. This is not a minor problem and can lead to complications.
So now you have several choices; 1) take medications for the rest of your life or 2) undergo and another more complex procedure to reroute the stomach drainage. The surgery may help, but is prohibitively expensive and you can rest assured, that some type of complication is likely.
With medications, you will feel better but there is no cure. If you develop complications from your gastric sleeve and the surgeon never told you about the problem, go and see a medical malpractice lawyer-this may not cure the problem but at least you will have a return of your money. For anyone who is thinking of undergoing sleeve resection, they should know about reflux, because it can be severe and very difficult to treat. If surgery to treat reflux is done at the same time as the gastric sleeve resection, another devastating complication can occur- you may not be able to swallow food and feel bloated all the time.

Do i need endoscopy?

2015-05-07T15:52:00.003-07:00

I was recently told I had peptic ulcer disease. The doctor insisted I undergo an upper endoscopy. I am only 42. Is this necessary?
Some of the biggest abusers of medical procedures just for financial gain are the gastroenterologists. Everyone who walks into their office nowadays get a scope down the mouth or up the arse. And this is not because they love your body parts but because they make a lot of money. Any astute doctor can make a clinical diagnosis of peptic ulcer disease. Sometimes a trial of peptic ulcer drugs may help determine the cause. My best advice to you is get some over the counter anti-ulcer medication and if you have peptic ulcer disease, the relief will be instant (in a matter of minutes). If that works you do not need any endoscopy. All this bullshit about Helicobacter pylori and taking 3 drugs is hogwash. It is just another money making scheme in medicine. Please change your doctor, because he /she is not interested in your welfare but your money.

2015-05-07T15:50:00.001-07:00

Benzl peroxide for acne?

2015-05-07T15:48:00.005-07:00

I have been using benzyl peroxide for my acne. Can it make my skin lighter in color?
Yes, it can. Benzyl peroxide is often combined with a drug called clindamycin for treatment of acne. It is useless for acne and a complete waste of money. This product has been out for almost a century and never works. You can use it topically, drink it, shower with it, use it as a suppository etc, but it will do diddly squat for your acne. If you are dark skinned and use benzyl peroxide, it can cause bleaching of skin. Benzyl peroxide is found in many skin products including peeling agents. It also can cause mild to moderate irritation and dryness of skin. If you have acne, this is not the agent of choice. Ask your doctor for a retinoid. Healthcare workers who prescribe benzyl peroxide are dummies and know very little about acne.

Melatonin for anxiety relief

2015-04-19T05:39:00.000-07:00

Can melatonin relieve anxiety?

Many people take melatonin by the kilogram each year. For some unknown reason people seem to think that melatonin is the magic pill for curing all mental health disorders. For the past two decades, melatonin has been used by insomniacs –now it is being promoted and an antianxiety agent. Many people develop anxiety for a variety of reasons and take melatonin. There are plenty of anecdotal reports on people who regularly use melatonin to treat their anxiety. But does it work?

Surprisingly at doses of 3-14 mg, melatonin has been found to be better than a sugar pill in relieving anxiety that occurs prior to undergoing any type of surgery. Other studies show that it is as good as the short acting benzodiazepine, midazolam. The downside to melatonin is that the effects are short lived and it does not seem to work if the anxiety is due to other causes (Eg panic disorder). Melatonin is available without a prescription and it is relatively safe. So if you have anxiety and have run out of options, try some melatonin. If it works you are in luck and if it does not, you got suckered.

Balneotherapy for rheumatoid arthritis

2015-04-19T05:33:00.000-07:00

Can spa therapy help my rheumatoid arthritis?

In the last two decades, balneotherapy which includes use of natural mineral waters, spas, mudpacks and other soils have been widely promoted for people with all types of arthritis. There are spas and mineral springs in almost every touristic area these days claiming that the therapy can relieve pain and swelling in patients with rheumatoid arthritis. There are 1000s of people going each year to the Dead Sea (Israel) and to the famous Bath spas (England) to expose their joints to the miraculous soil and water. But do all these mud packs and other similar therapies work for people with rheumatoid arthritis?

First the facts- spa and related therapies are very expensive. Most mineral spas can charge anywhere from $50-$100 just to soak your joints for 30 mins. Secondly, the spa and natural spring water for health is a billion dollar business. Third, most of the reports on the medical benefits of spas and mineral waters have never been scientifically verified. Finally all the hype you read is written by people who have a vested interest in selling this therapy to gullible and desperate people seeking miracle cures.

The majority of people who undergo spa therapy do feel great while they are soaking their body in the mud and soil. However, while mudpacks and spas do increase joint mobility for a short while, they do not decrease the intensity of pain or swelling. None of these therapies have long-lasting benefits.

At the moment, there is Zero evidence that balneotherapy can provide pain relief or slow down rheumatoid arthritis. While spas and mud therapies are safe and soothing, they are not cheap. So for people who have money to burn, sure go ahead and fly to Israel or Bath and try out the natural spas for yourself. For those of you who do not have money to waste, do not worry you are not missing out on anything. Save your money for food and other important things in life. You can get the same experience of Bath spa or Dead sea by soaking yourself in dirty warm water mixed with manure in your bath tub at home.

Can i prevent gestational diabetes?

2015-04-19T05:19:00.002-07:00

Is there a way to prevent diabetes during pregnancy?

Gestational diabetes occurs in 1-4% of women during pregnancy. The disorder presents with high levels of sugar at some point during the pregnancy. Women who are obese or have a family history of diabetes have a slightly higher risk of developing diabetes during pregnancy. When diabetes develops during pregnancy, the infant grows to a very large size and as a result can be injured at birth or cause injury to the mother during passage through the lower pelvis. So is there a way to prevent gestational diabetes?

Some people claim that by changing lifestyle one can prevent gestational diabetes. Unfortunately, there is little evidence to support that diet and exercise can prevent development of gestational diabetes. A large study showed no difference in the incidence of gestational diabetes in women who exercised and in those who did not. There is no harm in being active and eating healthy during pregnancy. But do not hold your breath as these
lifestyle changes may not be enough to prevent gestational diabetes.

Alpha lipoic acid for my neuropathy

2015-04-16T15:21:00.002-07:00

Will alpha lipoic acid work for my neuropathy?

Because most drugs used to treat neuropathy do not work, many patients are now turning to herbs and other supplements. One agent widely used to treat neuropathy is alpha lipoic acid. There are some diabetics who claim that after taking alpha lipoic acid the paresthesias lessen. Other people claim that the agent can also lower blood sugars and improve insulin sensitivity. In addition, alpha lipoic acid does not have many adverse effects and is a lot cheaper than pharmaceutical products. The agent can be used for several years with minimal problems.

However, even though doctors do recommend this agent, evidence for its benefits are not solid. The agent does not work immediately. Most people have to wait 6-8 weeks to see a benefit. Secondly in the clinical trials, the doctors used the IV formula and no one knows if the oral formula works because it has not been studied in randomized trials. The recommended dose is 600-1,200 mg per day. For diabetics who have severe neuropathy which has not responded to any medication, this agent may be worth a try. Alpha lipoic acid can be bought from any pharmacy and cost varies from $12-$20 (60 caps), depending on what brand you buy. You do not need a prescription. Final word: I would not buy more than 2 months’ supply- if it does not work within 6 weeks; you are not likely to see any benefit at all.

Swollen feet

2015-01-04T13:35:00.001-08:00

I am a 49 year old male and my feet are always swollen at the end of the day. Is there something I can do for this?

There are many things that can cause feet to swell up. If your blood pressure and kidney are fine, it may be that you are up on your feet all day. Being upright on your feet all day is a common reason for feet to swell up especially if you have varicose veins.

My best advice is to wear come type of compression stockings. You do not need to buy those expensive stockings that cost over $70. Go to a retail store like Walmart and they have decent compression stockings for $15. Wear the stocking first thing in the morning and that will prevent the feet from swelling. The stockings will also make your feet refreshed at the end of the day. The great thing about compression stockings is that they will also prevent development of varicose veins. These stockings come in all colors, sizes and gradients. Please do not buy these stockings from a vein doctor or any doctor for that matter- they will rip you off by charging you $50 and above for a pair of stockings.

Can i reheat food the next day?

2015-01-04T13:32:00.001-08:00

Is it safe to reheat and eat meat the next day?

Sure it is safe. This advice is usually given to morons, who do not know the first thing about bacteria or food. When you cook food, the heat kills the bacteria. But if the food is left outside at room temperature, it can be contaminated from fingers, utensils and other items in the kitchen. So if you are going to reheat food, it is best to store the food in the fridge after it is cooked. Next day, warm the food up. There are many people who cook food and leave it out for several days and then wonder why they develop diarrhea. There unfortunately is no cure for stupidity.