Ask the Dr.


A new study from Australia in European descendants showed that if you have hypertension or palpitations from your genes or other factors, you probably drink less coffee than those who don’t have symptoms since too much coffee makes you jittery; so you drink less than others with these genes or conditions.

Menthol makes it easier to start smoking, harder to quit, and jacks up the effects of nicotine so it is more addictive. Multiple medical and other organizations have been pushing the government to ban menthol. This has been known for years; finally, the FDA is banning menthol in cigarettes within a year. They banned flavored cigarettes (but not menthol) in 2009 since too many kids were vaping and becoming addicted to nicotine.

A group in Philadelphia had their application turned down by a judge to have a safe place to inject drugs. New laws are needed.
After our Civil War many veterans were in pain and opium and heroin were very cheap. You could buy an injection kit with syringes from Sears through the mail. The laws were very lax and opioid addiction was rampant. Physicians did not feel it was harmful and many of them became addicted and died. How times have changed with more knowledge.


Getting knowledge depends on how fast facts travel. Back in 1900 facts traveled very slowly but with the Internet, facts (and myths) travel at the speed of the electron. Use trusted sources for your information. If you read something on the web from an employee of a trusted institution, then you know they can be disciplined if they mislead others. I was told this when I worked for Riverside County and Borrego to not talk to the press and be careful what I say and write. But Joe Blow on the internet can say anything and not be disciplined. Whom are you going to trust?

Studies have shown that it is harder to stop watching the news with fear and scandal headlines than it is to stop watching news based on facts. What kind of record of truth do your news sources have compared to others? Saying, “I give up. They are all liars,” is not enough; some sources have a long list of false stories (this is perpetual, and approved lying) and others have a few mistakes and discipline staff who fabricate stories. What are you filling your mind with and how does it affect your behavior, relationships and health?
Take risk management. You decide to walk to the store to get exercise rather than drive. You have assessed the risks and benefits well. The risk of getting Covid and dying or having life-long Covid suffering is much higher than getting a serious vaccine complication. But it is easier to not do something that is unpleasant and take your chances vs. doing something that you won’t feel a direct benefit from. But you wear your seatbelt and wear a bike helmet for that rare event when they are truly needed. It is better to be an adult and assess risk realistically. In addition to the vaccine helping you, it helps those around you, whether loved ones or strangers.

The chief of Medscape and a thinker I respect, Eric Topol, MD, talks about Covid. He says all the variants so far are susceptible to the 3 vaccines we have in the USA, but new ones may come along. The more time a Covid virus is in a person, the more chance it can mutate to a worse variant causing increased ability to spread and/or to kill. The goal would be to vaccinate everyone so no variants have a chance to be produced. The B-117 variant spreads faster so it will become the dominant variant of Covid worldwide unless a new variant that spreads even easier emerges. When you get your vaccines you are helping yourself, your loved ones and the rest of the world.

We are damned if we do and damned if we don’t. When a journal article is found to be of low quality and retracted some say that science is corrupted and others say the system is working to weed out the bad. There was an article by Dr. Vainshelboim that said masks were not helpful and they were dangerous. This article was cited by many right wing people who are vaccine deniers. The journal found out he was not associated with Stanford University and the Veterans Administration hospital there as he said and that his conclusions were not true. To me, the system worked to identify lies that leaked into the respected information pool.

I had a patient today who said he was getting the vaccine just so he would not be looked down on by others and to be able to go to events. So far there are very few places that require vaccine proof for admission. Some schools and workplaces have this requirement.

Keep those questions coming and be safe!

Daniel Pearce, D.O., FACOI, AAHIVMS
Clinical Associate Professor of Medicine, Loma Linda University School of Medicine Adjunct Professor of Internal Medicine and HIV, Touro University California College of Osteopathic Medicine and Midwestern University Arizona College of Osteopathic Medicine HIV, Hepatitis B,C, Transgender, Suboxone Specialist, Borrego Health (Riverside, San Bernardino, San Jacinto) Member, Coachella Valley Clinical Research Initiative

REFERENCES: My notes and materials from CROI, Medscape®