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Too much sweat, not enough chlorine: A summertime reference to understand diabetes.

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...

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Concussions

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...

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Sneeze, Sneeze Go Away... Allergies, Ugh

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...

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Fever... when hot is too hot part 1

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...

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