by: daniel pearce, d.o., facoi, aahivms

There are risks you can and can’t change:
Can’t Change: age, sex, and genetic risk
Can Change: low level of education, physical inactivity, high alcohol intake, smoking, hypertension, and diabetes.
There are studies looking into improving these changeable factors and seeing if it prevents dementia. If you want to wait, then it may be too late. Now the education piece is tougher, but maybe keeping your mind active and having projects you care about will be helpful rather than sitting for hours watching the boob tube or doom scrolling on the web.
“A mind is a terrible thing to waste.” (Young & Rubicam) It is sad to watch and a lot of work to care for those whose minds are failing.
Healthy lifestyle: good nutrition, exercise, etc is important for many reasons.

Many who have hypertension that needs 3-4 meds at high dose should get a test called Aldosterone. It is a hormone that may be high. A simple pill at a low dose can have dramatic effects.

Many who survive their first cancer due to better treatments come down with a second cancer. Many times this is due to preventable causes: obesity, tobacco, and lack of a healthy lifestyle. Again, there are many benefits of the healthy lifestyle. You pay now or later. I will pay less since I am paying now by living a healthy lifestyle and the cost is not that much to lower my risk of strokes, heart attacks, cancer, etc.

The guidelines are as mentioned above but more detailed. The scientists recommended cutting simple carbs (sugars) down to 6% instead of 10% of the calories and cutting alcoholic drinks down more. It looks like the politicians ignored these recommendations and left the guidelines the same as the previous ones.
This influencing contrary to the evidence is not new. The American Dairy Association funded much of the nutrition guidelines and documents in years past. Some parts of the current government I trust and others not so much.

There are calculators that providers use to get a score on the risk for fractures, heart attacks, lung blood clots, etc. A risk score predicting whether a patient is going to have a heart attack soon has been used to urge the patient to have a procedure done. A calculator that seemed helpful has been used for years to recommend the workup. With more data and a larger, higher quality study, the calculator was not that helpful. It is good that physician/scientists keep studying and arrive at firmer conclusions which save complications from unnecessary procedures/surgery and unnecessary medications and visits.

A neurology expert says, “Neck restraints can lead to medical complications and death, even when applying very little pressure.” In light of those who have died as a result of this restraint, it is recommended to use other non-lethal means to restrain patients.

A large study of Emergency Department personnel in hospitals with high and low Covid exposure found that where masks were in short supply, more staff had antibodies to Covid than the places where there were enough masks. This is an association that the more masks are used covering the nose and mouth, the less Covid infections. Masks are important in preventing transmission of the corona virus from and to you.

A low or high percent of staff who had Covid antibodies was correlated to high or low levels in the community in which they lived. We know that our staff, hospital staff, prison staff, any business staff bring Covid into their workplace from home or bring Covid from home to the workplace. Lately with tighter controls, hospitals have had only rare transmissions so they are safe places, but certainly not as safe as your nuclear bunker stocked with food. 😊 Hospitals have enough tests and Personal Protective Equipment (PPE) and isolation procedures now, including using a PPE buddy—where a coworker inspects the PPE to make sure it is put on correctly. I remember this rule started when Ebola came to us and nurses were catching it.

Have happened. Now there is almost no one who doesn’t know someone who had Covid and more know someone who suffered and or died.
The virus doesn’t care if you need money, love your friends and relatives, or must enter a building. The delay between infection and symptoms is about 3-5 days and the virus test will be positive after about 3 days.

“But the Internet guy said Covid wasn’t real.”
Providers complain that, in the time of Covid, when a person is near death having discussions with family over the phone with an interpreter with masks on and a loud fan sucking out the germs in the room is not a good situation.
It is so important to sort out what you want and don’t want to happen before you are near death. Look up on the web: POLST Physician’s order for Life Sustaining Treatment and fill the form and bring it with your medications to the hospital.

Keep those questions coming and be safe!
[email protected]

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