Ask The Doctor

Carbs and depression

2015-08-08T05:01:00.000-07:00

Can carbs affect my depression?

Yes, there is a lot of data on foods that can affect depression. In general foods that have high dietary glycemic index scores, refined sugars and processed foods have been linked to risk of new onset depression, while foods with high dietary fiber, whole grains, vegetable and non-juice fruits have been associated with a low risk. If you already have depression, consumption of food with high dietary glycemic index can trigger or exacerbate your symptoms. So the take home advice is eat less processed foods and avoid too much of simple sugars. Remember there is no diet that can treat or cure depression. the sole most effective treatment for depression is medications. So do not substitute diet for antidepressant medications.

How can i gain weight?

2015-08-08T04:58:00.002-07:00

I have AIDs and would like to gain weight. Is there something I can take to improve my appetite?

Yes, try megace. It is a synthetic progestin which has been available for at least 70 years. It has been recommended for patients with have anorexia or weight loss due to cancers. How it works is a mystery. It does work in about 50% of cases. At least 5% of people develop adverse effects like diarrhea, abdominal cramps and men may have difficulty sustaining an erection. It is often given to cancer patients but I am not sure how great it works in these individuals. It does improve appetite but does tend to work slow. I would say try it for at least 2-3 weeks. It is relatively inexpensive and there are generic versions available. The agent is widely abused by bodybuilders and other athletes.

Itching and renal failure

2015-08-08T04:57:00.002-07:00

I have renal failure and often develop severe itching. Is there something I can use?

There are several things you can do. Use a moisturizer liberally. Keep the home humidified. Avoid excessive use of AC-which may not always be practical if you live in Florida or southern USA. You can apply topical hydrocortisone. Now there is a research study showing that topical vitamin D is very effective for the treatment of itching in patients with renal failure. While the drug is very safe, the down side is that it is also very expensive. My best advice is go with hydrocortisone-which is available OTC. Also use an oil based moisturizer and that should do the trick.

Blood thinner and atrial fibrillation

2015-08-08T04:56:00.004-07:00

I have atrial fibrillation and am on three blood thinners. Is this safe?

Atrial fibrillation is one of the most difficult disorders to treat. Converting patients to normal sinus rhythm with medications, surgery or with use of pacemakers does not always work. All patients with atrial fibrillation need to be on blood thinners to prevent stroke. The latest data is that most people do fairly well with 2 blood thinners. Use of three blood thinners also works but the risk of bleeding is also higher. You need to discuss this issue with your doctor; not a nurse or a pharmacist as they are clueless in the management of this serious disorder. Not even a general physician is good enough to give you advice on management of atrial fibrillation. Make sure you speak to an experience physician as this is critical. Strokes that occur in patients with atrial fibrillation are devastating. You will need to speak to a cardiologist and weigh out the risks and benefits of 2 versus 3 blood thinners. I can’t give any more specific advice

Oral sex and sore throat

2015-08-08T04:56:00.002-07:00

After oral sex, the back of my throat has become red. Have I acquired an STD?

I am assuming you are in a monogamous relationship, where there is no hanky panky going on. Women often give a blow job to men, and sometimes the man gets carried away and will start to thrust the penis at the back of the throat. When the thrusting of the penis is rough, you can develop small areas of hemorrhage on the soft palate at the back of your throat. This is nothing to worry about- it happens quite often but women do not exactly brag about blow jobs to doctors. Give your mouth a rest for a few days and the minute bleeding (called Petechiae) will disappear in no time. If you are not in a monogamous relationship and develop redness or a sore throat after giving a blow job to a stranger, get yourself checked out for gonorrhea. Pharyngitis caused by gonorrhea is on the increase globally.

Can calcium intake lower blood pressure?

2015-08-05T04:24:00.002-07:00

First let me get the facts straight. A lot has been written on calcium over the past two decades. Most of the anecdotal stuff has been written by uneducated people who do not even have grade 2 education. Social media sites like Facebook are full of wannabe doctors giving out BS advice on everything from surgery to nutrition. For example, a person, usually a female, takes calcium pills and notices that the blood pressure is low one day and then she starts blogging about the wonders of calcium. This person then starts to recommend calcium to every Tom, Dick and Harry. This is nonsensical medical advice and dangerous. Blood pressure control and modulation is dependent on hundreds of factors and there is no one mineral or supplement that controls it. In the majority of people with high blood pressure, there is no known cause. Almost everything underneath the sun has been tried out as a cure and failed. So simply telling someone to take calcium or vitamin D is bullshit advice.

The latest study shows that in YOUNG PEOPLE who do not have high blood pressure an increase in calcium may drop the blood pressure slightly. This indicates that perhaps regular calcium ingestion may be preventive against hypertension. However, these results should be viewed with caution as the mechanisms for this BP lowering are not known and the studies need to be reproduced. How much calcium to take, or for how long is not known. The current evidence suggests that in people over the age of 35 with normal blood pressure, a dose of calcium between 1000 to 1500 mg/day may be beneficial.

Having said all that, I should add that these studies on calcium were sponsored by the industry- and that usually means you have to think about the fudge factor. Doctors who are paid a lot of money to conduct trials usually always report positive results. My advice is always the same. To prevent high blood pressure, eat less, walk more and cut down on salt. If you want to add calcium there is no harm in it but do not expect miracles, because the blood pressure lowering is miniscule.

If you have been diagnosed with high blood pressure, I highly recommend you remain complaint with your medications- there is no substitute. High blood pressure is a silent disorder but it has devastating complications if it remains untreated.

Pilates for low back pain!

2015-08-05T04:16:00.001-07:00

Can Pilates help ease lower back pain?

Pilates were once hyped up as the best exercise for low back pain. People who recommended Pilates claimed that this exercise was very beneficial and had a lot of health benefits. I am not sure about a lot of health benefits but it is a good form of exercise. As far as low back is concerned, only a few randomized studies have been done to assess the benefits of Pilates. The results indicate that Pilates is better than sitting on your butt for relief of low back pain. On the other hand, it is no better than any other type of exercise. What this means is that Pilates is not superior to any other exercise for low back pain. Plus, there is a whole bunch of razzmatazz behind Pilates like breathing techniques and precision to make it work. If you like Pilates, go ahead and it can help ease mild to moderate low back pain. If you are like me and not a stickler for rules and regulations, do any type of exercise and you will have the same benefit.

Can I lose weight with Phaseolus vulgaris (common bean)?

2015-08-05T04:14:00.001-07:00

People who live in Mexico and South America have been making claim that the common bean has anti-obesity effects. Millions of Hispanics and Latinos consume the common bean regularly and some claim that they do not put on weight. Many reports exist that the common bean can suppress appetite and mobilize fat reserves.

However studies on the common bean have not yielded any significant benefits when compared to a sugar pill. In one study, some individuals lost 3 kg over 26 weeks after eating common beans every day. Bottom line is that you could lose that much weight by walking alone.

Plus remember, after eating the common bean you will pass flatus, which is very offensive. So unless you are a hermit living on Mount Everest, this is not a great supplement for weight loss.

Should I eat a Low fat or low carbohydrate diet for weight loss?

2015-08-05T04:11:00.000-07:00

For decades, people who have wanted to lose weight were told to stick to a low fat diet. Now there is a change in thinking. Low Carb diets are fast gaining attention and some experts believe that they can help obese people lose weight and sustain the weight loss. One recent study showed that a low Carb diet was as good as a low fat diet but the differences in overall weight loss were not that different. Until more long-term studies are available, the choice of diet for weight loss is strictly personal.

Final note, unless you starve yourself, there is no diet that can help you lose weight if you sit on your butt all day. If you exercise, you can lose weight with almost any diet. Remember all this diet stuff is a billions dollar business designed to scam gullible and lazy individuals. If you want to lose weight, walk more and eat less.

Is the new ReShape balloon for weight loss available?

2015-08-05T03:58:00.000-07:00

Yes Reshape the balloon for weight loss has just been approved by the FDA. The balloon has a dual shape and the reason for this is to prevent slippage into the intestine. The Reshape balloon is placed in the stomach during an endoscopic procedure. The doctor uses a flexible scope to place the balloon and then inflates it with about 500 cc of saline. Once the balloon is inflated, it makes you feel full and you no longer feel hungry. The procedure requires mild sedation and is done as an outpatient. So does it work?

In one small trial, after 3, 6 and 12 months, people who had the balloon did have weight loss. However, you also have to remember that the study was sponsored by the makers of the balloon. The study was not randomized nor was it blind. The person who performed the study received money from the manufacturer of the device- so that alone should be an indicator that results may be fudged.

Adverse effects during this study included constant abdominal discomfort, nausea and vomiting. A few patients required early removal of the balloon. The cost of the balloon procedure is about $15,000 and add in another $5,000 for miscellaneous expenses. So should you go for the Reshape balloon to lose weight?

If you have money and are too lazy to walk, sure, you can go ahead. If you have money and have common sense, I do not recommend it. Similar balloon treatments for weight loss have come and gone without much success. The lap band was a similar procedure but failed miserably. Plus, there is always a risk of serious complication like the balloon moving into the intestine and that means having a formal surgery procedure to remove it.

My advice has always been the same for people who want to lose weight –walk more, eat less and you will have the same result. Walking is usually without any complications (unless you are texting and get hit by a car) and it is free.

Hypnotherapy for weight loss

2015-07-11T05:02:00.001-07:00

Recently I was recommended hypnotherapy for weight loss. Will it help?

Hypnotherapy is a bogus therapy. Do you think that by closing your eyes and listening to some hocus pocus nonsense, you will lose weight? Wake up- hypnotherapy is junk science. Save your money from this nonsense. All hypnotherapy will do is give you depression after you find out that you spent thousands of dollars and did not lose an ounce. There is Zero scientific evidence that hypnotherapy works for weight loss. The only people who benefit from this therapy are the people who offer it. If you want to lose weight, walk more, eat less. There is no other magic bullet.

Remember hypnotherapists are not real doctors and from what i have seen they are nothing more than quacks who scam money from desperate people.

Treating hypochondriasis

2015-07-11T05:01:00.001-07:00

My sister is a hypochondriac. Is there a treatment for this condition?

Hypochondriasis is a very common disorder; just go on to any social media like Facebook and all you will ever read is about the multiple illnesses people have (real and imagined). Every single day, these individuals have a different medical disorder or have a cockamamie story about a fictitious illness in someone in their family. Hypochondriasis is a very complex disorder and one of the most difficult to treat. The disorder is more common in women and it appears that anywhere from 10-20% of women are preoccupied with some type of imaginary illness all their life. The disorder is episodic and may last months to years and then disappears.

Many people with hypochondriasis have another psychiatric disorder like depression, generalized anxiety or panic disorder. In general, if there is a primary psychiatric disorder like depression, it can be treated with medications but if the individual only has hypochondriasis, psychotherapy is offered. Unfortunately psychotherapy often does not work and most individuals are not compliant with this therapy. No one likes to listen to bogus crap by therapists-so they just do not show up for the sessions. Plus psychotherapy is not cheap. The more stupid you look, the more sessions they enroll you for. The prognosis for hypochondriasis is variable. For those with good family support, 50% recover. Others continue to fake illness and eventually meet a surgeon, who really frecks them up for good.

The prognosis in children is much better than in adults.

Cream for cellulite

2015-07-11T04:58:00.002-07:00

I am a 21 year old with cellulite at the back of my thighs. is there a cream i can buy to get rid of it?

No, there is no such cream. All the ads about creams to remove cellulite are bogus. The more expensive the cream, the less likely it will do anything. There is no cure for cellulite. Women fret about cellulite and this had led to a multi billion dollar anti cellulite industry with scammers and con artists- with the majority being healthcare professionals. Best advice is walk or exercise. If the cellulite really bothers you take a Prozac. PS, no surgery can help cellulite either. So if you are thinking of liposuction, you will be even more disappointed with the results.

How do i stop biting nails?

2015-07-11T04:55:00.001-07:00

Is there a medication to stop nail-biting?

Nail biting is a difficult habit to give up. There are many people who regularly bite their nails leading to nail deformity, poor cosmesis and anguish. So far no herb, lotion or potion has been found to be effective in treating nail biting. Some experts recommend painting nails with a bitter solution - known as aversion therapy, this sometimes helps. Take something you absolutely hate and paint it on your nails and this may deter you from biting your nails. Others recommend wearing gloves. I think that perhaps treating your anxiety at the same time may help. See a good psychiatrist and let him decide if an antidepressant that relieves anxiety may help resolve this problem. In many cases, s short course of an SSRI may help. good luck

Bedwetting in a 38 year old

2015-07-11T04:53:00.002-07:00

I have suddenly started to wet my bed. I am a 38 year old female. What should I do?

In general bedwetting starts at a young age and then in most cases spontaneously subsides. About 1-4 percent of children will continue to wet the bed as adults. If bedwetting suddenly starts at an older age, there is usually a cause. Disorders like diabetes and urinary tract infections are common causes. My best advice is to see a urologist and let him/her work you up. Please do not go to a general practitioner-these MDs are incompetent when it comes to dealing with bedwetting. When you have sudden onset of bed wetting you need to find out the cause. In the meantime, drink less water at night and avoid sugar beverages. If you cant get to the bathroom in time, wear a diaper.

Exercise for quitting smoking?

2015-06-13T08:21:00.005-07:00

Can exercise help people quit smoking?

Quitting smoking is a difficult task; most of the drugs available today are JUNK and a complete waste of money. One non-drug therapy that is often advocated to help people quit smoking is exercise. Many types of exercise have been advocated.

The great news is that over 12 months, evidence shows that people who exercise are more likely to quit smoking and remain nicotine free. Exercise is not only cheap but safer than any drug. This does not mean everyone join an expensive gym. Even simple walking regularly is of benefit. So if you want to quit smoking, start walking today. The only difficulty with exercise is that many people do not have the motivation to use their legs.

Naltrexone to help quit smoking

2015-06-13T08:21:00.002-07:00

Can naltrexone help people quit smoking?

Naltrexone is a long acting opiate antagonist. It is an expensive drug and often used to treat addiction to opiates and alcohol.

As far as smoking concerned, the drug has been tried; the results revealed that it was not at all effective as an aid for smoking cessation. The best method of quitting smoking is still cold turkey. Everything else is a gimmick designed to scam you of your hard earned money.

Acupuncture for smoking cessation: Part 2

2015-06-13T08:20:00.001-07:00

Nevertheless, the question is, "does acupuncture actually help people quit smoking?"

Researchers recently looked at several studies where acupuncture was used to help people quit smoking. The results were then compared to the nicotine replacement therapies.

The overall conclusion was that acupuncture was not effective in helping people quit smoking. Similar failure rates were observed with laser therapy, acupressure and electro-stimulation. For consumers who want to quit smoking, almost all treatments available today are nothing more than scams.

Most treatments to help people quit smoking are prohibitively expensive and the majority of individuals see no benefit.

What should be remembered is that the tobacco industry is a big business and all the major studies on smoking cessation are sponsored by these companies. Worse, many of these companies pay doctors big dollars to assess the study- so do you think that any doctor who is paid large sums of money will report anything negative?

Cold turkey is the only proven therapy that actually helps people quit smoking, and is free. All the rest of therapies (drugs and non-drugs) are a complete waste of money, with low cure rates and high rates of failure.

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000009.pub3/abstract

Acupuncture for smoking cessation Part 1

2015-06-13T08:19:00.000-07:00

Acupuncture to Quit Smoking

If they could, many smokers would like to quit this addictive habit. However, nicotine addiction is complex and not well understood. So far, no treatment has proven to be a magic bullet.

Smokers continue to spend billions of dollars in search of a treatment to discontinue smoking. All the available nicotine replacement products designed to help people quit smoking have been an abysmal failure.

The failure of conventional medicine to help curb the desire to smoke has led many people to turn to alternative care remedies.

One such remedy that is touted to help people quit smoking is acupuncture. This traditional Chinese therapy is still not accepted in mainstream medicine because doubts continue to exist about its efficacy.

The insertion of needles to stimulate certain points in the body and maintain good health or prevent disease appears to be a far fetched concept among conventional healthcare providers.

Acupuncture to help people quit smoking is not a one shot deal and requires many sessions, with each session lasting 30-45 minutes. At the end of the sessions, the acupuncturists claim that the individual will have less desire to smoke.

No one knows if the effects of acupuncture are sustained with time. There are no data on relapse rates. It should be noted that each session of acupuncture can cost anywhere from $75-$200

Treating spider veins

2015-06-13T08:17:00.002-07:00

Which is the best treatment for spider veins?

Laser is slightly better than sclerotherapy and can be used to treat spider veins on both the face and legs. However, laser is painful; results are not guaranteed and the treatment is prohibitively expensive.

What is cost of spider veins?

Spider veins are considered cosmetic and not covered by any Medical insurance carrier. The cost of spider vein treatment is variable. If sclerotherapy is used, the treatment may cost anywhere from $200-$400 per leg. If lasers are used, the cost may be 2-3 times that.

Final point

Remember, there is no permanent cure for spider veins and recurrences are common with both treatments. After treatment, spider veins do recur within a few months. Considering the economic times, one should think twice about undergoing a treatment, which is expensive, painful, and there is no guarantee that it will work. Like all things in cosmetic medicine, there are no refunds.

More on spider veins

2015-06-13T08:16:00.001-07:00

How can one get rid of spider veins?

Spider veins on the legs can be removed using two methods. One is sclerotherapy and other is laser. Sclerotherapy involves injection of an irritant chemical into each spider vein. The irritant chemical causes collapse of the vein. The vein is then slowly removed from the body in a few weeks. Each spider veins requires a needle prick. After the procedure, compressive garments have to be worn for about a week.

Laser is another way to treat spider veins. The procedure is fast, has little down time and the results are fairly immediate. Laser unfortunately is fairly expensive.

How are spider veins on the face treated?

On the face, spider veins can be treated with laser. The treatment is fast and effective. The current lasers also come with a cooling tip so that the pain is minimized. Some people require 2-4 sessions of laser to remove all the spider veins. After laser treatments, there may be some mild swelling and redness.

Can spider veins recur?

Yes. The only bad news is that spider veins can recur. Recurrences occur with both treatments.

How can I prevent spider veins?

On the leg, preventive steps include the wearing of compressive stocking and avoiding weight gain. On the face, one must keep out of the sun to avoid spider veins. A sunscreen is highly recommended for all individuals who want to avoid spider veins.

Spider Veins 101

2015-06-13T08:14:00.003-07:00

Spider Veins

Spider veins are common in millions of individuals. They are known as spider veins because of their appearance. The lesion has a dark center with small lines radiating away from the center. Why spider veins occur is not fully understood but has been linked to excess sun exposure and excess pressure in the small veins.

Where do spider veins occur most commonly?

Spider veins are most common on the face and legs. On the face, spider veins have been linked to sun exposure. They typically appear on the nose and cheeks. On the legs, spider veins are most common on the back and front of thighs and near the knee. Women who stand all day and those who take the birth control pills are also prone to spider veins.

Can spider veins cause symptoms?

All individuals should understand that spider veins are harmless and only a cosmetic problem. Spider veins do not cause any symptoms. If any individual complains of pain, swelling, itching, or numbness-the cause is not spider veins. The majority of women come to see a physician only because spider veins are unsightly and the problem is cosmetic. If you have spider veins and complain of PAIN, then you need to see a psychiatrist and not a surgeon. Spider veins are harmless and cause no symptoms. Because women fret over spider veins for cosmetic reasons, the treatment brings in billions of dollars for doctors.

Everything Acne: Can dermal fillers help me get rid of my acne scar...

2012-11-24T05:31:00.001-08:00

Everything Acne: Can dermal fillers help me get rid of my acne scar...: Dermal fillers simply means injecting tiny amounts of collagen or fat underneath the scar depression. This will elevate ...

Can dermal fillers help me get rid of my acne scars?

2012-11-24T05:30:00.003-08:00

Dermal fillers simply means injecting tiny amounts of collagen or fat underneath the scar depression. This will elevate the skin lesion and make it smooth. The scars can be minimized but there is no guarantee it will work.

Dermal fillers are not a permanent treatment for acne scars and the treatment is also expensive- hundreds of dollars per session. Knowing how cosmetic surgeons work, they will probably ask you to come in every few weeks until they have ripped you off a few thousand dollars so that they have enough money for a down payment on a Mercedes.

Unless you have deep acne scars and lots of money, this method is not recommended. You have to understand, that anytime you get a surgeon to do a procedure, there is a chance that things can go wrong. Therefore, you can end up worse.

Everything Acne: Can dermabrasion help me with my acne scars?

2012-11-24T05:29:00.001-08:00

Everything Acne: Can dermabrasion help me with my acne scars?: First you have to know that dermabrasion is a real shit technique. All it involves is using a rotary device with a brus...