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Five Conditions That Are Risky for Covid-19

Why do some people get severe illness and even death with Covid infection, and others develop a mild illness or no symptoms at all?  One of the answers to that question is the five associated conditions that we now know lead to severe Covid -19 infections. These five underlying conditions increase the risk for severe Covid-19 and they are highest in counties in the Southeastern United States and in more rural counties and urban areas.

People with one or more of these conditions had hospitalizations that were six times higher, ICU admissions that were 5 times higher and deaths 12 times higher that people without the conditions.

High risk conditions for severe Covid-19:

Chronic kidney disease (CKD)Chronic obstructive pulmonary disease (COPD or Emphysema)DiabetesHeart DiseaseObesity, defined as having a body mass index (BMI) 30 or greater Now get this! In the United States the median prevalence of any of these 5 health conditions is 40.7%.  Some Counties were over 50% prevalence. Obesity -…
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I Have Gout - Now What?

Any Doctor will tell you that in medicine, things come in threes.  As expected, I diagnosed three cases of gout this week.  If you have been told you have gout you may wonder "Now what?"
Gout can affect anyone and it usually occurs quite suddenly, often at night.  It is caused by uric acid crystals that deposit suddenly in a joint, most commonly the big toe, but any joint can be affected.  Patients describe deep throbbing pain that is very intense and sometimes even a sheet touching the joint can cause exquisite pain.  The pain is worse within the first 12 hours.
Uric acid is present in our blood and gout occurs when the urate levels are too high and deposit crystals in the joint.  Uric acid is made from purines that are broken down from certain foods such as steak, seafood and organ meats.  Alcohol and juices sweetened with fructose are also causes of excess purines.  Usually uric acid is excreted in the kidneys but if there is an excess in the blood or if the kidneys can'…

Why I Don't Check Covid Antibodies in Patients

We are (at a minimum) 5 months into the worldwide Covid-19  pandemic that has upended all of our lives.  We have been told "testing, testing, testing" is needed and will be our way out to get back to normal.  There is still massive confusion about testing so let's try and make some sense out of it.
First some definitions:

The Covid-19 nasal or throat swab test-  This is the test that we are promised "Anyone can get" and most of the time it will reliably diagnose Covid infection.  These tests are now provided in labs, drug stores, drive through testing and some specialized medical offices.  Because they deal with patients who might be infected, the front line testers have to have full PPE to protect against the virus.  Depending upon the test, the results are ready between 24 hours and up to a week.  This test has up to a 20% false negative rate, meaning it will say there is no infection, even if a person is infected.  The test has to capture the virus when it i…

Burn Care. What You Should do at Home

Approximately 500,000 patients In the United States seek medical care for burns each year and 92% are treated as out-patients, according to the American Family Physician.  Burns are classified by depth.

Superficial burns are called first degree. They are localized to the outer (epidermal) layer and are painful, red and dry.  These burns do not blister and they take about 3 days to heal. A bad sunburn or quick stove burn is a first degree burn.
Partial thickness burns are called second degree. The epidermal layer is destroyed and they are very painful and usually blister.  Most will heal within three weeks or sooner.
Deep partial thickness burns involve the reticular dermis underneath the epidermal layer and they are usually dry. These are third degree burns. They take more than three weeks to heal and often cause loss of skin and scarring.  Deep partial thickness burns should receive immediate medical attention and sometimes even need skin grafting.
Full thickness burns extend through t…

Hydroxychloroquine for Covid-19 is Dead

Physicians and Scientists everywhere, led by Anthony Fauci, have been saying "Lets wait for the data on Hydroxychloroquine as a treatment for Covid-19".  Well, we now have that data and it is irrefutable that Hydroxycholorquine and Cloroquine, with or without a macrolide antibiotic (Azithromycin), does not work for Covid-19 and, in fact, causes increased death.

In case you are wondering about the guy who says "Hey, my uncle has been taking it and he got better in six hours", or "Hey, I know lots of people who take it every day and they are just fine", let me explain this Lancent study for you.

The researchers studied 671 hospitals on six continents involving 92,036 patients.  They looked at hospitalizations from Dec 20, 2019 through April 14, 2020.  Patients who were given Remdesivir were excluded.  The mean patient age was 53.8.

They formed two groups, a control group given standard treatment and a Hydroxychloroquine or Chloroquine group with and witho…

Covid Fatigue...the Good and the Bad

We have entered a new phase of the global Covid-19 pandemic.  After 9 weeks of shut-down in some areas, twenty-four hour a day news, and our lives completely disrupted, many are entering into a phase of Covid Fatigue.

The adrenaline rush that has sustained front-line caregivers is starting to wane and the grind of wearing uncomfortable PPE and seeing the virus described as a hoax makes crawling out of bed an effort.  Essential service people like food supply chain (farmers, pickers, packagers, processors, transporters, stockers and grocery clerks) have been doing double duty, caring for children, managing their own lives as well as going to work every day with fear.  And this includes police, firefighters, sanitation workers, food prep, cleaners, your local cable guy and everyone working from home too.  Covid Fatigue is part depression, part anxiety, part fear with a hint of hopelessness thrown in.
 "Will this ever end? Will I have a job? Will I be homeless? Should I close my bu…

Antibody Testing for Covid- Not So Fast

Image from The Verge - Vox
I wrote a couple of weeks ago about the importance of having antibody testing for Corona Covid-19 as a pathway forward for resuming activity and work. Antibody tests are now being offered at urgent care clinics, private doctor offices, Labcorp labs and by the time you read this, there may be home antibody tests offered from ads online.

 I'm getting many requests a day from patients who think they had Covid if they had any illness from December onward.  "I want to know if it is Covid and if I am immune."   It is vitally important for us to know who has had the virus, who is immune from future exposure and who is safe for asymptomatic passing of the virus.  But...and this is a big BUT...antibody testing today is NOT READY FOR PRIME TIME.

Let's break this down.  Why?

The FDA has relaxed its usual standards and has permitted emergency use authorization for antibody testing.  This means Neighbor Joe can get some funding, throw some reagents toge…