If you’re diabetic you’re probably familiar with the term hemoglobin A1c. However, if your doctor is concerned you’re “prediabetic” meaning you’re knocking on the door of type 2 diabetes, then this is a lab value you need to understand. 

When you are diagnosed with diabetes, it means you have too much blood glucose (sugar) floating around in your system and your body isn’t able to create enough insulin to combat all the sugar you’re consuming. Think of your body like a pool. People with sunscreen (carbs that get broken down into sugar) and sweat (sugar) are getting in the pool making it cloudy. The pool has chloride (your insulin) to fight the sunscreen and sweat so that the pool stays nice and clear despite all the people in and out BUT when all the chlorine storage is depleted (type 1 diabetes) or there are just too many people in the pool and the chlorine demand can’t keep up (type 2 diabetes) and the sweaty, sunscreened...

With the onset of warm weather and the spring soccer season, I am bracing for the recurrent questions regarding concussions.  Such is the life of a dad physician cheering from the sidelines. Though it is true that the fast pace, aggressive play, and frequent hard contact of soccer are a set up for this injury, many other mechanisms can be at play.  Most associate concussions with high impact, high velocity incidents; however, even less forceful traumas can be the cause, particularly when sudden and rapid head movement is also associated.  This knowledge is important:  1) we need be vigilant that, though helmets are helpful in reducing fractures and some contact forces upon vital structures, they do not add full protection against shearing forces and resulting injuries; 2) we must be observant with even less forceful injuries, such as an elbow to the head, standing up an hitting your head on a low beam, or a fall even when no obvious impact occurs, to give a...

If you see someone wearing a mask it may not be because of the ‘rona it may just be because they don’t want to breathe in all the pollen flying through the air. 

Those lucky enough not to suffer from seasonal allergies may not understand what the big deal is but let me paint you a little picture. The cells in your body are just minding their own business when all of a sudden the air raid sirens start going off like. Not like the weekly tornado test sirens that we all ignore, but like seek-a-bomb-shelter type alarm starts going off inside our body and our cells start freaking out. Histamine and leukotrienes start being produced causing an increase in blood volume resulting in congestion and inflammation [hello runny nose, sinus pressure, headache, flushed skin, itchiness, watery eyes] The histamine is how our cells are trying to combat all the pollen entering our body. The body knows this pollen is a foreign intruder. And since our cells make terrible preppers they...

 In the last blog, here, I explained why we develop a fever sometimes due to infection. I also explained some other characteristics of the person with a fever that would require that I take a closer look: overall appearance, extremes of age, a poorly functioning immune system, and some social issues I must consider. 

I had alluded to the fact that not all fevers are due to an infection. Now, I want to explain some of the issues that can cause elevated body temperature when no bacterial or viral culprit is to blame.

Illicit Drugs

Certain illicit drugs, like amphetamines, can cause body temperature to elevate higher than what we usually see with infectious causes. MDMA (ecstasy), a common rave drug, causes users to want to have move their bodies more (like dance), it causes increases in serotonin, and it causes the cells themselves to release energy as heat rather than storing it. 

Drug-drug interactions

Sometimes prescription or over-the-counter drugs can interact...

I remember one time I was working at a large hospital, and about 1 am a mother brought her toddler in with a rectal temperature of 106.5. Even for those of us who see a lot of kids with fever, that’s pretty high. We did a full evaluation including blood work, x-rays, and lumbar puncture and got the kid admitted to the pediatric service while we waited to see if the blood cultures grew anything.  This child did fine and went home after a couple of days. Fevers continue to be one of the most common reasons people come to the hospital or see their doctors, especially in the pediatric age group.

I like to educate people about fevers because there are so many misconceptions. Everyone’s grandmother has an antidote for fever. Everyone knows someone who knows someone whose “brain was fried” due to fever. So many myths, so little time…

Aside from some unusually high fevers, usually caused by issues other than infection (discussed in the next...

Our collection of health tips

Vitamins

Where to start? Think about starting with a multi-vitamin. Typically, a multi-vitamin has 7 ingredients:

Vitamin D
Magnesium
Calcium
Zinc
Iron
Folate
Vitamin B12

**But if you struggle with constipation a multi-vitamin with iron may worsen the problem.

Not all vitamins are created equal. Look at the quality of the vitamins. Read the instructions. Some are best taken with food, some without. Remember, vitamins are used to supplement what you aren't receiving from a proper diet.

Migraines

Migraines are miserable. Understanding your migraine triggers can be key to keeping your pain at bay. Did you know food triggers can occur up to 24 hours after consumption? By tracking your food you are more likely to zero in on a pattern and begin experimenting with eliminating certain foods from your diet. Even though Excedrin Migraine contains caffeine to help combat your migraine, too much caffeine can cause rebound headaches. By tracking and potentially...

One reason I’m excited about this new venture into direct primary/patient care is finally having the focus and time to foster best communications and relationships with my patients.  

Said communication goes both ways: it need be an intricate, complicated “give and take.”  

Yet in some instances, unfortunately, in my years at the bedside, I have noted amongst my peers (and I confess, with me, too), a dynamic that has increasingly evolved into a wholly paternalistic: “I [doctor] will give you [patient] what you need and you will just accept that.”  Time constraints, external pressures, insurance companies and government, quality measures, practice guidelines, meaningful use, blah blah blah, can further work to add to a more domineering, less interactive, “take it or leave it” approach in the care of our patients.  Though I do believe that my evaluations and resulting plans are sound, I still must earn the confidence of my...

An interesting fact about superheroes: Most of them have to go through some pain to get to the place where they are recognized for their extraordinary abilities. They may have to wander some monumental path of discovery and enlightenment, or they may have to traverse a deep valley before ascending the mountain to become the stoic guardian of their domain. During their journey, however, you would probably dismissed them as average and unworthy of recognition. Batman had to watch his parents be killed and then train to be the knight he becomes. Ironman had to catch shrapnel near his heart before necessity and opportunity intersected to birth the Marvel Cinematic Universe. 

If superheroes are born from strife and develop superpowers as a result of the difficulties they encounter, let me pose a question: What’s your superpower going to be? What have you fought hard to recover from (or are still battling) that can equip you to impact the world around you? There are...

Key Points:

• Intervening in our loved ones life delaying or shielding them from consequences may not actually bless them. 
• Protecting them from hurt and not enabling is a fine line. 
• You're delaying their healing by protecting them from feeling pain. God disciplines us via consequences. 
• As a father myself, initially I'm going to intervene with my own wisdom and instruction and then my own discipline. But let's say that's not working and my son is in jail for the second or third time. Would my bailing him out be a hinderance to him feeling the weight of consequences for his decisions? 
• Facing consequences is an opportunity for me to actually experience growth. It's an opportunity for my character change, evolve to get stronger, but when I'm spared consequences, guys, you take away my opportunity to become better. You take away my opportunity for life to teach me some lessons.

Full transcript:

Hey guys, Dee Bonney here. I wanted...