Heartburn at Home

Heartburn: How to Handle the Heat

Whoever dubbed the searing pain of acid indigestion “heartburn” got it right. The (usually) benign phenomenon can come on suddenly and have you wishing for an internal fire extinguisher to make it stop. Fast.

An estimated 60 million Americans experience heartburn at least once a month. Because it’s so common, our concierge doctors in Jupiter, Florida, want to explore the causes of heartburn, ways to prevent and treat it, and when you should be concerned about it.

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best face mask

Which Type of Face Mask Is Best?

We’ve been living with the coronavirus pandemic for a year now. Our concierge doctors are seeing more and more claims regarding special types of face masks that will supposedly offer more protection from the virus.

We’re also getting more questions from our patients on this subject. Especially now that at least three variants (mutations) of the coronavirus have been identified as circulating in this country.

So we thought we’d tell you what we know to date on how to find the best face mask.

Anti-microbial masks

Manufacturers have been producing so-called “anti-microbial” facemasks for months now. They claim to offer greater protection against the coronavirus. In Europe, brands such as Under Armour, Burberry, and Diesel have been marketing masks said to reduce viral activity that comes in contact with their masks.

Experts are dubious about these assertions. In the U.S., firms are prohibited from making claims like this without providing evidence. Neither the Centers for Disease Control and Prevention (CDC) nor the U.S. Food and Drug Administration (FDA) has so-far approved anti-microbial masks to prevent the spread of the SARS-CoV-2 virus.

Amy Price, a senior research scientists at Stanford Anesthesia Infomatics and Media (AIM) lab, advised the World Health Organization (WHO) on its face mask guidelines.

“The challenge is that sometimes claims are made, but they aren’t tested on the actual masks with the actual virus,” she told CNN on a video conference call. “So they’re like gimmicks.”

Dr. Charlaynn Harris, Ph.D., MPH, senior epidemiologist at Unity Band, makers of a wearable COVID-19 tracker, told POPSUGAR she wouldn’t recommend any mask not fully vetted by the FDA.

“I do feel as though these products could lead to false security for the wearer,” she added. “Claims of being antimicrobial lead the wearer to believe they have an added barrier against this highly infectious pathogen.”

Copper-infused masks

What about copper-infused masks, which are also selling briskly?

It turns out that it is true that copper kills viruses and other pathogens. When both bacteria and viruses come into contact with copper, they are killed “very quickly and without mercy,” Dr. Michael Schmidt told The Washington Post recently. Schmidt, professor of microbiology and immunology at the Medical University of South Carolina, studies the use of copper in health-care settings.

Comparing the reaction to “an exploding grenade,” he said viruses are no match for copper.

“The oxygen shrapnel first destroys the envelope,” of the viruses, he told The Post. “Then, additional oxygen radicals come in to destroy the viral RNA, and if the instruction set is not intact, you have no virus.”

There is a catch with copper-infused masks, however. The particles of the virus must actually come in contact with the copper strands within the mask. If it doesn’t touch the copper, it remains intact, and active. So copper-infused masks are still no guarantee of safety.

One side note on copper supplements, which are also being touted to protect from the coronavirus: Don’t take them. According to the Office of Dietary Supplements at the National Institutes of Health (NIH), ingesting high amounts of copper can lead to liver damage. And such unfortunate gastrointestinal side effects as abdominal pain, cramps, nausea, diarrhea, and vomiting.

Double-masking?

Remember that the coronavirus is transmitted primarily through the air, by both infected droplets and aerosols. This is why it so easily and stealthily passes from person to person.

And we now have three confirmed variant strains of SARS-CoV-2 in the U.S. All of which are far more transmissible than the strain we’ve been fighting for the last year.

Therefore, some experts have begun recommending that everyone wear not just one but two masks.

“The reason for that is you do wind up getting more filtration of viral particles,” Dr. Dave Hnida told CBS Denver. “It becomes more of an obstacle course for the viral particle to make its way from the air into your nose and throat and then into your lungs.”

We still have a shortage of medical-grade N95 masks, which filter out 95 percent of pathogens. So wearing two masks at the same time can offer better protection. In fact, wearing two can offer nearly the same protection as the vaccines, according to Joseph Allen, an associate professor at the Harvard T.H. Chan School of public Heath.

“A surgical mask with a cloth mask on top of it can get you over 91 percent removal efficiency for particles,” he told CNN.

Fit is key

Whichever type of mask you choose, if it doesn’t fit properly, it won’t work to protect you or others.

The CDC offers the following guidelines to find the best face mask for you:

  • Choose masks that have two or more layers of washable, breathable fabric.
  • Make sure the mask fits snugly against the sides of your face and doesn’t have gaps.
  • Do not choose masks that have exhalation valves or vents. These allow virus particles to escape.
  • Completely cover your nose and mouth. Note: If you have a beard, the mask cannot completely cover your nose and mouth. You might want to consider shaving it off until masks are no longer necessary.
  • If you wear a gaiter, use one with two layers, or fold it to make two layers.
  • If you wear glasses, find a mask that fits closely over your nose. Or find one with a nose wire to limit fogging.
  • Face shields are not recommended.
  • Scarves, ski masks, and balaclavas are not substitutes for masks. Wear a mask under each of these items.

Remember, the only mask that works—not only to protect yourself but also to help stop the spread of the virus—is the one that is worn consistently.

benefits of supplements

Supplement Benefits: All In the Mind?

It sounds so easy: Pop a pill (or pills) every day and enjoy radiant health. Unfortunately, our concierge doctors have to caution you that it may not be not that simple. And, according to a new study, the claimed benefits of taking supplements might not even be true.

The study, published this month in the journal BMJ, suggests that the perceived benefits of over-the-counter (OTC) vitamin and mineral supplements may largely be due to the power of the mind.

“The effect of positive expectations in those who take multivitamin or mineral supplements is made even stronger when one considers that the majority of them are sold to the so-called worried well,” lead study author Dr. Manish Paranjpe said in a statement. “The multibillion-dollar nature of the nutritional supplement industry means that understanding the determinants of widespread multivitamin or mineral use has significant medical and financial consequences,” he added.

The financial aspect is obvious. Dietary supplements are a $40-billion-a-year business in this country. And if the products don’t work as expected, that’s a huge waste of money.

The medical impact is less well known. Between 2007 and 2012, the U.S. Food and Drug Administration (FDA) received reports of more than 6,300 reports of serious adverse events linked to dietary supplements. These included 115 deaths and more than 2,100 hospitalizations.

What’s the harm in taking supplements?

This may surprise people who think that because these substances are sold over the counter they can’t do you harm. Others believe that the government wouldn’t allow their sale unless they were safe and effective. However, a 1994 law, the Dietary Health and Education Supplement Act, actually prevents the FDA from regulating dietary supplements or removing them from sale unless it can prove a supplement is unsafe.

But indiscriminate use of supplements can produce serious side effects. For example, Vitamin E and beta-carotene supplements can actually increase the chances of developing lung cancer in smokers.

St. John’s Wort is sold over the counter for mild depression. Some of its potential side effects include dizziness, sun sensitivity, insomnia, anxiety and headaches. It can also reduce the effectiveness of birth control pills and some heart medications.

Fish oil can cause nausea and diarrhea and increase the levels of LDL (bad) cholesterol. It can also increase the risk of bleeding. Some people have suffered such severe liver damage with green tea extract that they required a liver transplant.

Niacin, another popular supplement, has been shown to slightly increase the risk of death from any cause. So have calcium supplements, which one study suggested increased the risk of death from cancer when taken in amounts greater than 1,000 milligrams per day.

Little evidence for real benefits

Then there’s the question of whether these products are effective for the reasons we take them. Various studies have been performed on the efficacy of supplements in the prevention of many diseases. All have shown little-to-no benefits of dietary supplements and vitamins.

Those marketed for the prevention of cardiovascular disease (CVD) have, for example, been studied extensively. In 1996, the Physicians Health Study assigned 22,071 men to take either beta-carotene or a placebo for 12 years. They assessed the effect of the vitamin on the prevention or progression of the disease. The results showed no difference in either CVD occurrence or overall mortality.

A Women’s Health Study found a similar result when it looked at the effect of beta-carotene on 40,000 women. It found no differences in the incidence of heart disease between those taking the vitamin and those receiving the placebo.

Another study published in the Journal of the American College of Cardiology that examined multivitamins, calcium supplements, and vitamins C and D, found no measurable advantage in terms of preventing CVD, heart attack, stroke, or early death. A similar study found no CVD-associated benefits for vitamin D.

Yet the belief persists

Despite these findings, many people still swear they notice a difference in their health after taking supplements. The study this month attributes this to the power of belief. Consumers also point to studies that support their faith in these substances.

An article in Harvard Women’s Health Watch, however, explained that the benefits of supplements that often appear in some studies are based on observational research vs. clinical trials. That is, researchers ask study participants to self-report on their daily habits, vs. performing randomized controlled trials. Because observational studies don’t control for diet, exercise, and other variables, they can only suggest an association with better health benefits from particular supplements.

“People who take supplements tend to be more health conscious, exercise more, eat healthier diets, and have a whole host of lifestyle factors that can be difficult to control for fully in the statistical models,” Dr. JoAnn Manson, chief of preventive medicine at Brigham and Women’s Hospital and professor of medicine at Harvard Medical School, told the journal.

So whether you’re trying to improve your health or ward off illness, your best bet is to follow the time-honored advice: Consume a balanced diet, including fruits and vegetables, get plenty of exercise, don’t smoke, use alcohol in moderation, and avoid recreational drugs. It really is that simple.

flu shot twindemic

Flu Shots Can Help Avert a ‘Twindemic’

The U.S. Centers for Disease Control and Prevention (CDC) recommends all adults and children older than six months receive a flu shot by the end of this month. The CDC says it takes at least two weeks for the vaccine to become effective. Then it won’t reach its peak effectiveness until another week after that. And children who are being vaccinated for the first time need two vaccines spaced a month apart to become fully protected.

Therefore, our concierge doctors suggest you get your flu shot for the 2020-21 influenza season as soon as possible. While there have been scattered reports of shortages around the country, The Washington Post recently reported a record number of flu vaccine doses—between 194 million and 198 million—have been ordered. Because the vaccine is shipped in stages, more is on the way.

“This year I think everyone is wanting to get their vaccine and maybe wanting it earlier than usual. If you’re not able to get your vaccination now, don’t get frustrated. Just keep trying.”

The CDC’s Dr. Daniel Jernigan, to the Associated Press (AP).

COVID-19 and flu overlap: a ‘twindemic’

We were fortunate the 2019-20 flu season was winding down this spring as the coronavirus crisis began to hit the country. This year, however, we’ll be looking at the possibility of a “twindemic”—both waves hitting at once.

So it’s especially important that as many people as possible get vaccinated for the flu this year. The flu shot won’t prevent COVID-19, but it can help reduce the strain on our already overburdened health care system.

“Since hospitals and doctors’ offices are going to be very busy caring for COVID-19 patients, a flu vaccine can help decrease burdens on the health care system and make sure that those who need medical care are able to get it.”

Dr. Susan Bailey, president of the American Medical Association (AMA) and an immunologist in Fort Worth, Texas, told CNN.

Last year, the CDC estimated that the flu killed 22,000 Americans, and resulted in hospitalization of an additional 400,000. By contrast, at least 215,000 Americans have died of COVID-19 since March.

Hopeful signs

Health experts are hopeful the precautions we’ve been taking to avert COVID-19—hand washing, social distancing, and wearing masks—will mean this season’s flu won’t take as severe a toll as in previous years. But they all insist that widespread vaccinations are necessary.

Even if the flu vaccine isn’t 100 percent effective in preventing influenza, it has been shown to reduce the length and severity of the illness in those who contract it. In addition, if you’re unlucky enough to contract COVID-19, you won’t want your body’s defenses to be weakened by a prior bout with the flu.

This is already present in the Southern Hemisphere, where each season’s flu strikes over the summer. From South Africa to Australia, public health experts reported remarkably low levels of influenza among their populations. They attributed this partly to coronavirus lockdowns and to extremely high participation in influenza vaccinations.

One pharmacy in Cape Town, South Africa, for example, reported that the demand for flu shots was four times higher than in previous years. People were trying to avoid the co-morbidity (simultaneous presence of two or more diseases) of contracting the flu in addition to COVID-19.

“People were lined up outside the pharmacy down to the corner of the street waiting to get their injections. We had to prevent people from coming into the store.”

Ellis Henen, owner of Sunset Pharmacy, told The Post.

Additional benefits of the flu shot

We hope Americans will have the same attitude to this year’s flu shot.

Some people think they’re still protected from the one they received last year. But having received a flu shot last year won’t protect you from this season’s strains of the virus. This is because your immunity from a year ago has deteriorated by now. In addition, manufacturers create a new vaccine each year based on which strains the World Health Organization (WHO) expects to be predominate. This is based on which strains were seen over the summer in the Southern Hemisphere. So this year’s shot will include strains different from those in last year’s inoculation.

It’s important to remember, even if you contract influenza after receiving the shot, it’s likely to be less serious than if you’d skipped being inoculated. And the flu vaccine offers additional benefits, especially among the elderly. For older people and those with chronic health conditions, recent studies show the extra benefits of a flu shot. It’s as effective in preventing a heart attack as quitting smoking, using cholesterol-lowering drugs, or taking blood pressure medications.

So be sure to let us know if you’re interested in getting a flu shot. If you encounter a shortage, we may be able to help you locate a supply nearby.

Fall Allergies

Prepare Now for Fall Allergies

We love the sunny, warm weather here in southern Florida, but unfortunately it’s also a recipe for an extended allergy season. We not only get a longer time to encounter summer pollens, including flowers and grasses, soon we’ll be having to deal with the fall-blooming ragweed as well as mold allergies that arise from our state’s hot, humid weather.

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coronavirus covid19

How Viruses Work and How to Stop COVID-19

Our concierge doctors thought this would be a good time to tell you about viruses in general, especially the novel coronavirus known as SARS-CoV-2, aka COVID-19. SARS-CoV-2 is the name of the virus; COVID-19 is the disease it produces. This nomenclature is similar to the human immunodeficiency virus (HIV) and its resulting disease, acquired immune deficiency syndrome (AIDS).

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