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

A large review of the evidence found that the studies showing the newer medications, e.g. Celexa, Paxil, Prozac, Cymbalta and the older medications such as amitriptylline were weak when they concluded that they helped with pain. This is disappointing, of course. One expert said, “A better approach is multidisciplinary rehabilitation (MDR), which coordinates medical therapies with physical and cognitive therapies and biofeedback, as well as dietary counseling, mindfulness, and acupuncture.” Our wish for a pill to take care of it all is not to be fulfilled. Sad.

We thought that potatoes were a big starch packet with a little fiber and vitamins. Now more data shows that diabetes is not enhanced by potatoes and you feel fuller the heavier the weight of the food; potatoes are heavy with water. Also, they contain more nutrients than previously thought, blood sugar does not spike, and if you like potatoes then eat some as a healthy dietary item. Careful: fried potatoes add many calories due to the oil. I use minimal oil and put some water in the frypan to unstick food.

Most diabetes drugs in this class help you lose a small amount of weight, <20 lbs in a person 300lbs or so. But Ozempic can help you lose more weight but not get you to the weight you really need. Many people unrealistically depend on a pill instead of diet and exercise with or without the pill. You can "out-eat" any medication. Ozempic can cause facial fat loss like some older HIV meds, this is lipoatrophy, causing more caving in of the face and more deep wrinkle lines. There is a shortage of this medication since many think it is the cure-all for their obesity; diabetics are going without this needed medication due to the fad. 23 ALMONDS ARE A SUPERFOOD? Almonds have some amazing properties. 23-40 Almonds can suppress appetite due to their fiber, fat and protein content, in addition to lowering diabetes risk and lowering appetite hormones so that they help weight loss. ULTRAPROCESSED FOOD ASSOCIATED WITH HIGHER RISK OF CANCER DEATH. Ultraprocessed food, such as soft drinks, chips, chocolate, candy, ice-cream, sweetened breakfast cereals, packaged soups, chicken nuggets, hotdogs, fries and more. These are packaged foods which have a long list of ingredients that don't contain food items but do contain chemicals or derivatives of food. Fresh foods, cooking from scratch are the best way to avoid these chemicals. E.g. flour, vegetables, rice, pasta, fruits. Read the labels. E.g. tomato paste is just tomatoes and water. Whereas canned soup can have many chemicals listed as ingredients that you won't remember are foods, since they are not foods. OBESE PATIENTS CUT DIABETES RISK IN HALF By exercising. This study was done over 10 years. Now running would be harmful for obese patients, but speed walking, running or swimming in the pool, rowing machine, elliptical stepper would be good examples where you could get your heart pumping, break a sweat and not damage your joints. JOGGING HURTS KNEES? A new study of knee MRIs before and after running, including marathons, showed mild damage but temporary; the knee repaired. Caution: this was in normal knees and there is no data on knees with arthritis which may be damaged further by running. EARLY ALZHEIMER'S MARKER? A new test which may be available soon is a marker for Alzheimer's Disease before symptoms develop. If this pans out, then one could plan to start their bucket list earlier. Also it helps researchers treat these patients to see if a new drug postpones or prevents Alzheimer's Disease. SIGHING HELPS MOOD Meditation was not as good as sighing repeatedly for 5 minutes. The sighing consisted of taking a fast, deep breath and letting it out slowly and repeating for 5 minutes. This exercise helped calm people down better than other types of breathing techniques or meditation. COVID HASN'T BEEN BAD FOR THESE HIV PATIENTS who are fully vaccinated with the newest double power (bi-valent) vaccine that came out about October last year, and who have a low viral load. I CAN’T FIND MY KEYS Or I can’t remember where I parked my car. Are these signs of dementia? Usually not. We get distracted and forget to leave our keys in the correct place. We forget to try to remember where our car is parked, looking around for landmarks or post markings. Distraction is usually the cause. We need to be mindful, in the moment to avoid these problems. COVID KILLED 36OO HEALTH CARE WORKERS IN THE US We forget that health care workers are on the front lines and when a new pandemic is just getting started they are the ones likely hit in large numbers. Having a concentrated exposure to many people in a health care setting with a virus increases the odds of transmission. I was pulled out of clinic to work remotely from home in March 2020 and we returned with masks May of 2021 with limited in-clinic visits. Now we and the patient mask up. There are only 300 deaths a day in the US now from Covid, which is much lower than before. Only 300? That sounds jaded! People still don’t cover their nose in my clinics. I agree that the general prevalence (amount of Covid around us) is going down and that health care settings are the last place that should remove masks. Keep those questions coming and be safe! 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® 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