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I want to take the best possible Covid 19 vaccine. Which one is the best?

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Question: I want to take the best possible Covid 19 vaccine. Between the Pfizer-BioNTech, Moderna, AstraZeneca and Johnson vaccines. Which one is the best? I am a 54 year old woman with no health problems.

Answer: Hi. There has been a lot of talk about the efficacy of the different vaccines and talk about some folks preferring one to the other because of its efficacy % rate, etc. But I would recommend you take whichever vaccine is offered to you first.  All these vaccines are highly effective against severe illness caused by covid 19 and that is what really counts. Just to give you an idea, when it comes to flu shot vaccines the average efficacy is between 40 to 60%. But all covid 19 vaccines are efficacious 70% plus! And when it comes to severe illness they all range near the 80-95% range. That is really impressive for any kind of vaccine! So getting any one of these vaccines will do what it takes to protect you.

Regards,

Dr. D. Zluf

Dr. D. Zluf

My body wants to keep moving to the right?

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Question:  I HAVE BEEN RUNNING FOR PAST 60 YEARS, I’M 75 NOW. MOSTLY LONG DISTANCE HAVE COMPLETED 56 MARATHONS, MANY HALF AND 5K RUNS. LATELY, AFTER RUNNING THREE MILES HAVE LOWER SPINAL PAIN, BODY WANTS TO KEEP MOVING TO THE RIGHT, UNABLE TO CONTROL BALANCE. HAVE TO HOLD ONTO OBJECTS AFRAID OF FALLING OVER. I TEND TO GO OFF TO THE RIGHT?
THANK YOU

Answer: Hi. I have received and read your question. In my opinion, your history of marathon running and heavy use has led to a condition of excess Foot Supination/Pronation – an imbalance of the foot. This can be treated by consulting a specialist (sports physical therapist) who will recommend specific exercises. Also you should reevaluate your foot wear with a orthopedic shoe specialist and find a shoe that can correct the problem.

Regards,

Dr. John Claude

Excessive supination (underpronation) and excessive pronation (overpronation) can cause problems with the body’s alignment and lead to pain in the feet, knees, hips, and back.

  • Too much supination can cause problems, such as pain and soreness.
  • Most people with excessive supination have structural issues in their feet.
  • Ways to treat or prevent excessive supination include wearing proper shoes.

People who pronate excessively roll their foot inward, causing the outer part of the heel to make contact with the ground and the feet to flatten too much.

Those who supinate do not roll their foot inward enough. This puts a strain on the ankle and can cause the ankle to roll outward, which leads to injury.

Excessive supination is less common than excessive pronation.

Causes of supination : The structural problems of the feet causing supination are usually inherited. However, external factors can also play a role in the condition.

Common causes of excessive supination include:Traits that affect the mechanics of the feet and legs are often inherited, such as:

  • leg length (including differences between the length of the legs)
  • width of the foot
  • ankle stability

The shape of the foot’s arch may also increase the risk of supination, with runners with high arches being more prone to supination than other people.Good shoes support the arch and soft tissues of the foot, which help protect the foot from injury. This is especially true when walking on hard and flat surfaces.

The wrong type of shoe — such as rigid or tight shoes — can lead to supination and other foot problems. Also, wearing shoes that are worn out or have no arch support causes supination.

Can I add DHEA and Pregnenolone to improve my hormone levels?

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Question: Hello, I suffered a stroke 30 years ago both my adrenal glands were removed and I now rely on 20 mg Hydrocortisone and 0.1 mg fludrocortisone a day Can I add DHEA and Pregnenolone 25/100 mg to improve my hormone levels i.e. Reduce my psa levels

Answer: Hi. I have received and read your question. Based on the information you have provided and considering the medications you are taking, I would not recommend taking DHEA or Pregnenolene. Both have questionable results with insufficient evidence of effectiveness. In addition, they are banned in some countries for certain activities. I hope this answers your question.  Below is some background additional info for you.

Serum levels of the adrenal androgen, dehydroepiandrosterone (DHEA) and its sulfated conjugation product DHEAS, peak in men and women in the 3rd decade and decrease progressively with age. Increasing numbers of middle-aged and older individuals consume over-the-counter preparations of DHEA in the hope that it will retard aging by increasing muscle and bone mass and strength, decreasing fat, and improving immunologic and neurobehavioral functions. To date, however, the benefits and risks of DHEA administration for “anti-aging” purposes have not been defined. Because DHEA can serve as a precursor to testosterone (T) and estrogen, supplemental DHEA use may pose a cancer risk in patients with nascent or occult cancer of the prostate and/or breast.

Regards,

Dr. Deepak Patel

Should I take a vaccine to improve my immunity?

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Question: I went to hospital 2 weeks ago and now have received the results of my immunity test. I don’t understand what these mean. Is there a problem that I should know about? I was prepared for the test – no meds etc. Should I consider to take a vaccine in the future? Please help.

1. HAV-IgG to Hep A – 11.48 (reactive).

2. Mumps – 47 (positive).

3. Rubella – 46.2 (reactive).

4. Measles – >300 (positive).

Thank you very much for you assistance.

Answer: Hello. Thank you for your question. Immunity concerns have been more in the forefront today what with the corona virus situation and more. Based on the info you have provided it is my opinion that you have no need to worry despite the results turning positive. For instance, for hepatitis, the virus that is considered to be dangerous is hepatitis B, all the same, you may need to take hepatitis immunization. For the MMR (measles, mumps, and rubella) mostly a large number of people that are tested tend to have traits of it not unless you are symptomatic, there is no need for alarm, but again I would highly recommend you take the vaccine for the same.

Regards.

Dr. Deepak Patel

I went to ER, strep test was negative but doctor said it must be strep?

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Question:

I am 21-year-old female. I am pretty healthy and have an average weight. I had a sore throat for two days and it is extremely hard to swallow due to swelling to the point I can barely eat solid food. It is not scratchy, and I do not have a cough or fever.

I went to the urgent care, strep was negative but the doctor said it must be strep and would not listen to any of my symptoms. He spent about 30 seconds with me and is treating me with Biaxin. Pain is killing me, and my stomach is having a hard time with these antibiotics even with food. I am attaching a photo.

Answer:

From the picture we received, you seem to be suffering from acute follicular tonsillitis. Usually, this is caused by strep, other bacteria responsible for this condition are Hemophilus and Moraxella. A course of antibiotic at this stage helps in early recovery. As you have been started on macrolide antibiotic, I believe it is the best course of action at this stage – you need to follow the whole course for it to be effective.

Antibiotics are known to cause gastric upset, which usually disappears once the course stops. If this is too difficult to endure ask your Doctor for  Zantac (Ranitidine) 150 mg and take before food twice daily and use warm salt water gargles at least three times a day. If situation continues, please follow up with your Doctor after seven days.

Regards,

I hit my head on a wall.

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Question: I hit my head on a wall. I am feeling pressing sensations in my left temple. Just recently I feel much smaller sensations in my right temple. Not painful just pressing. What is going on?

Answer: A blow such as the one you have received may have no consequences whatsoever. Using pain relief medication such as Acetaminophen (Tylenol) may help with the pain. Please avoid using ibuprofen (advil) for such an injury. You will need to consult if you have subsequent symptoms. Immediate medical attention is required if you experience symptoms such as bruising behind the ears or around the eyes (raccoon eyes). These can potentially indicate a severe or life-threatening injury. If you experience these symptoms, a CT scan will be required to further evaluate the situation. Sometimes a blow to the head may produce a concussion. These are difficult to diagnose. And the consequences vary. Most concussions or mild traumatic brain injuries (MTBI) symptoms will go away without treatment. So please continue to monitor your situation and should symptoms worsen please consult for more investigation.

Additional Information:

Head injury can be either closed or open (penetrating).

  • A closed head injury means you received a hard blow to the head from striking an object, but the object did not break the skull.
  • An open, or penetrating, head injury means you were hit with an object that broke the skull and entered the brain. This is more likely to happen when you move at high speed, such as going through the windshield during a car accident. It can also happen from a gunshot to the head.

Head injuries include:

  • Concussion, in which the brain is shaken, is the most common type of traumatic brain injury.
  • Scalp wounds.
  • Skull fractures.

Head injuries may cause bleeding:

  • In the brain tissue
  • In the layers that surround the brain

Common causes of head injury include:

  • Accidents at home, work, outdoors, or while playing sports
  • Falls
  • Physical assault
  • Traffic accidents

Most of these injuries are minor because the skull protects the brain. Some injuries are severe enough to require a stay in the hospital.

Will a person suffering from Crohn’s disease be more pre disposed to get MND?

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Question:

Hi I have become paranoid that my boyfriend is going to develop MND at some point In his life and it’s not that rare and I think because he has crohn’s disease that it will make him more pre disposed to get MND. But if he has a disease already will it make it less likely to happen?

Answer:

There is no reason to believe that because your boyfriend has Crohn’s disease that there is necessarily a greater chance of developing MND. There is a 1 in 300 risk of getting MND across a lifetime. It can affect adults of any age, but is more likely to affect people over 50. MND often begins with weakness of the muscles in the hands, feet or voice, although it can start in different areas of the body and progress in different ways. It is in hereditary in about 10% of the cases as far as the remaining 90% due to a number of factors including auto immune response issues, exposure to viruses, toxins and ageing of motor neurons. Unless there are existing symptoms which may lead you to believe your boyfriend may suffer from MND, I would not focus on that and stop thinking about it.

Here are some additional factors for your information:

The physical effects of motor neurone disease can include:

  • muscle aches, cramps, twitching
  • clumsiness, stumbling
  • weakness or changes in hands, arms, legs and voice
  • slurred speech, swallowing or chewing difficulty
  • fatigue
  • muscle wasting, weight loss
  • emotional excess – for example, where a slight upset can cause an exaggerated response, such as crying or laughing
  • cognitive change (changes in thought processes)
  • respiratory changes.

Doctors often find it difficult to diagnose MND in the early stages as it can resemble other conditions, such as mutiple sclerosis  (MS). If a doctor suspects someone has MND, they will refer them to a neurologist, who will take a medical history, do a thorough examination, and may suggest other tests, such as:

1. Blood and urine tests: These can help a doctor rule out other conditions and detect any rise in creatinine kinase, a substance that muscles produce when they break down.

2. MRI brain scan: An MRI cannot detect an MND, but it can help rule out other conditions, such as stroke , brain tumour, or unusual brain structures.

3. Electromyography (EMG) and nerve conduction study (NCS): An EMG tests the amount of electrical activity within muscles, while a NCS tests the speed at which electricity moves through muscles.

4. Spinal tap, or lumbar puncture: A doctor will look for changes in the cerebrospinal fluid, which surrounds the brain and spinal cord. It can help rule out other conditions.

5. Muscle biopsy: This can help detect or rule out a muscle disease.

The doctor will normally monitor the individual for some time after the tests before confirming that they have MND.

Dr. Javez Ernesto

I suffer from extreme blood pressure problems, how can I get my BP down?

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I suffer from extreme blood pressure problems. I now have 198 over 72 but cannot get it down. I went to an ER and there they gave me a Nitroglycerin patch which helped reduce it to 180. Doctor prescribed Coversyl 5 – 2.5 but it doesn’t seem to work. I have had heart surgery with valve.

Male
Age: 52
Medications: Coversyl, Coumadin