Charlotte fell one day while walking to her car, landing painfully on her side on a concrete curb divider. The back pain that followed did not go away. In fact, it began to crescendo into sciatic radiation down the left leg along the side of the calf and into the foot. After a month of suffering with this pain, she came to the clinic.
Her physical exam revealed exquisite tenderness over the middle to lower lumbar spine such that I could not palpate the muscles deeply. There were significant muscle spasms in the lumbar spine. Movement was difficult with much guarding when trying to walk. The orthopedic and neurological exam showed evidence that she was getting significant pressure on the fifth lumbar nerve.
I want to introduce you to Amy. She is in her early 30s, working in an office where she does a lot of computer work, data entry, customer service, and other tasks associated with small office work. Her hours are long, but the nature of the work is such that there are seasonal surges with steady work in between. She is a happy, pleasant and well-adjusted young lady, married with two children. She writes magazine articles and sings for enjoyment.
She came to see me because she had pain in the left side of her chest, radiating down the left arm to the fingers. The arm pain was associated with numbness and tingling. The condition caused her some anxiety because it was recurrent. This pain and numbness had begun the day before she came to see me, but it was far from her first episode. She even sometimes awakens with one or both arms numb and tingling, and this is particularly true of her left arm when she sleeps on her left side.
Question: Is there a provision in the Affordable Care Act (Obamacare) that forces doctors to ask about gun ownership as part of a health history? A pediatrician told me it is included in Obamacare.
In the wake of Newtown, several noted pediatric specialists have called on their colleagues to ask parents about gun ownership and safe storage of firearms as a part of their medical history for children. The assumption is that owning a gun is a health risk to all of the family in the residence. The American Academy of Pediatrics also recommends that doctors talk with families about safe gun storage.
Question: I have a lot of headaches, so I take a lot of Tylenol. How safe is it? It's an over-the-counter drug, so wouldn't it have passed the FDA approval process?
I do a lot of DOT physicals in the practice. One commercial trucking school student I examined was a twenty-five year old Caucasian male who looked very healthy in most respects. His urinalysis showed that his kidneys were leaking blood and protein in significant amounts. His blood pressure was in the 220/110 range, and he felt fatigued. He was having to urinate two to three times hourly and was craving water. When I probed his history, I found that because he suffered from chronic sinusitis, he had taken Tylenol Sinus formula three times daily for about a year and a half. His kidneys were ruined. I called a nephrologist for him from the trucking school parking lot.
With the holidays here, families are gathering in one place to celebrate from distant places-- exposing family members to germs from across the country. We can expect colds and flu to make the rounds. Flu vaccine—the most effective way to prevent the flu, according to the Centers for Disease Control and Prevention—remains a controversial subject. Why?
First, most flu vaccines still contain thimerosal, a mercury-based preservative. This preservative is found in many household and over-the-counter preparations, including many contact lens solutions. It is not uncommon to have or develop an allergy to this preservative.
Rhonda once visited with me in the clinic a couple of times every month with lumbar pain. She was active physically, and stressed, so she needed some maintenance work. She took a six-month hiatus from care before I saw her the next time. She was a different person. She was relaxed, de-stressed, flexible, happy, and about 40 pounds lighter. What had Rhonda done to create such a metamorphosis? She had found a yoga/Pilates class, and she continued her stretching at home. She looks 20 years younger than her stated age.