HEALTH

FAILURE TO LAUNCH

By: Daniel Pearce, D.O., FCOI, AAHIVMS

FAILURE TO LAUNCH
Maybe you have an adult sibling who can’t seem to become independent of their parents and have difficulty getting and keeping a job, even though many jobs are available.
This failure may be due to anxiety and seeking professional, mental health help is in order. The parents can slowly wean the benefits of living at home to make it financially advantageous to move out, e.g. they can slowly increase the rent to the point that the rent is higher than other rooms to rent. Realize that rent may cover many other items like using a car, meals, cable, wifi, laundry.
Of course, if they have a mental illness that is more serious and a different approach is needed. It is hard to balance the amount of tough love to use with children; parents disagree on how to approach their children.

IS YOUR SLEEP WORSE WHEN YOU OWN A CAT OR DOG?
Downside: more restless nights and sleep disorders. Pets sleep and wake on their schedule, not yours.
Upside: Pets reduce stress and help anxiety and depression, offer a sense of security and companionship which combats loneliness. Some have better sleep due to these benefits.

MY CPAP IS TOO NOISY AND HARD TO CARRY AROUND
The most common treatment for sleep apnea is a CPAP machine (continuous positive air pressure). Some have trouble with their masks not fitting or making them uncomfortable and therefore not used. The newer ones are smaller and quieter but must be taken on trips away from home along with the tubing. There are certain nasal and oral appliances that are gaining in popularity lately that keep the airway open and prevent blocking so you can breathe and snore more quietly. If these are not an option, then there are multiple surgical methods to help with this.
Relieving sleep apnea relieves its risk for obesity, hypertension, and cardiovascular events.

NEW DEFINITION OF HIGH BLOOD PRESSURE
Now stage 1 Hypertension is defined as BP more than 130/80. It used to be 140/90. If you have more than a 10% risk of a heart attack or stroke in the next 10 years based on a risk calculator, then you should be on a cholesterol medication and start a blood pressure medication. If you smoke or have diabetes, then your risk is high for these cardiovascular events. My two clinics have an automatic calculator built into the electronic medical records instead of me pulling out my phone and inputting data from multiple pages in the record. This is amazing and more accurate since I may mis-type the data.

MELATONIN GUMMIES HAVE MORE THAN LISTED ON THE BOX
A recent study showed that these gummies have 34% more melatonin than listed.
This highlights that unregulated “Food” advertised as medicine is quite variable in what they contain. Look for the little box on these products that comment on the claims of the sellers, “These statements have not been evaluated by the Food and Drug Adminstration. This product is not intended to diagnose, treat, cure or prevent any disease.” The FDA makes them put these labels on if they have not done the studies to prove their claims.

VEGETARIAN DIET IS NOT TOP OF THE LIST TO PREVENT CV EVENTS
I am a vegetarian and that diet gets a score of 86 in preventing cardiovascular events (heart attacks, strokes, etc). I am a ovo-lacto (eggs and cheese OK) and that diet has the same score as a vegan.
Pescatarian (vegetarian with a side of fish) scores 92.
The best diet is the DASH diet: 100 (whole grains, beans, avoiding white starches and palm/coconut oil, processed foods, low salt, minimal sugar, alcohol. DASH is Dietary Approaches to Stop Hypertension, showing us how the diet got invented.
Mediterranean allows alcohol: 89
Vegan and low fat diets: 78
Very low fat: 72
Low Carb: 64
Paleo: 53
Low carb Keto: 31

COVID LIFE GOOD FOR KIDNEYS
People ate out and cooked at home more during Covid so they didn’t add so much sodium and calcium to their diets. This reduced blood pressure and prevented kidney stones in many people. Some found eating at home better and so now after Covid they eat out less.

IF YOU DENY A MEMORY PROBLEM, THAT MAY INDICATE ALZHEIMER’S
A neurologist in Boston followed 436 patients with normal brain skills for 11 years. The people who had memory problems but knew it and were concerned about it and admitted it probably didn’t develop Alzheimer’s disease but those who denied it were more likely to develop Alzheimer’s disease.

PRIMARY CARE DOCTOR SHORTAGE WILL AFFECT YOU
Here are some reasons: less pay, physician graduates are on average a half a million dollars in debt. This will result in long waits for appointments. I am waiting 2 months to see an eye doctor at Kaiser for a routine check.
Same day appointments are available at CVS Minute Clinics, telemedicine services, Urgent Cares; Amazon and Meta (Facebook) are getting into healthcare. Technological advances are making health care more accessible but with less continuity.
I have patients who have gone to a Minute Clinic, Urgent Care, or to a hospital. They have a poor grasp on what happened, and records may take months to get to me. How do I provide care without information? The providers at these places rarely communicate with me.

At Loma Linda’s SAC Medi-Cal clinic, I do get notices if a patient has gone to a place that has the same electronic medical record software. On Wednesdays I can see what has happened on a small number of patients. My other clinic and many other places my patients go have different software.

Another method to help this shortage of providers is the training and graduating of Nurse Practitioners and Physicians Assistants. They are very good at diagnosing and treating common problems and consult a physician when a problem seems outside of their expertise.

BE KIND TO CHILDREN
Childhood trauma can result in a life of anxiety and/or depression, asthma, diabetes, and cardiovascular disease. Please help other adults to check themselves and be kind when they correct a child.

Keep those questions coming and be safe!

dpearce@western.edu
Daniel Pearce, D.O.,
FACOI, AAHIVMS
Associate Professor of Medicine, Loma Linda University School of Medicine HIV, Hepatitis B,C, Transgender, Suboxone Specialist, Neighborhood Health (Riverside, Hemet), Loma Linda SACH (San Bernardino) Member, Coachella Valley Clinical Research Initiative
REFERENCES: Medscape®