Posted in Entertainment, Health, news

Alan Alda Admits to Battling Parkinson’s

The lovable doctor from M*A*S*H was diagnosed with the neurodegenerative disorder three years ago.

82-year-old, award-winning actor, Alan Alda reveals he is battling Parkinson’s Disease.

During an interview on CBS This Morning, the actor stated, “I’ve had a full life since then.”

I’ve acted, I’ve given talks, I help at the Alda Center for Communicating Science at Stony Brook. I started this new podcast. And I noticed that – I had been on television a lot in the last couple of weeks talking about the new podcast – and I could see my thumb twitch in some shots and I thought, it’s probably only a matter of time before somebody does a story about this from a sad point of view, but that’s not where I am.”

What is Parkinson’s Disease?

Parkinson’s disease is the second most common neurodegenerative disorder, next to Alzheimer’s, and the most common movement disorder that affects 1% of the world’s population over 60 years old. In the US, 60,000 new cases are diagnosed each year.  It affects several areas of the brain, primarily the substantia nigra, altering balance and movement by affecting dopamine producing cells.

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IMAGE FROM THE SCIENCE OF PARKINSON’S DISEASE

It was first described in 1817 by James Parkinson as a “shaking palsy.”

What are the Symptoms of Parkinson’s?

Common symptoms of Parkinson’s include:

  • Stiffness and rigidity
  • Poor balance
  • Tremor at rest, especially a pill-rolling tremor
  • Slow movement
  • Inability to move
  • Shuffling steps, gait

and patients may later develop…

  • Depression
  • Anxiety
  • Memory loss
  • Constipation
  • Decrease ability to smell
  • Difficulty swallowing
  • Erectile dysfunction
  • Pneumonia
  • Fractures from falling
  • Hallucinations
  • Delusions
  • Dementia

Who is at Risk for Parkinson’s?

Most cases are idiopathic, meaning the disease arises with no specific cause.  However some cases are genetic and multiple genes have been identified that are associated with the disease.

The average age of onset is 60, but some cases may occur as “early onset”, before the age of 50, and if before the age of 20, it is known as juvenile-onset Parkinson’s.

Men appear to be more affected than women at twice the rate.

Risk may be enhanced with a history of head trauma.

Exposure to herbicides and pesticides has been linked to an increase risk of Parkinson’s as well.

 

How Quickly do Parkinson’s Symptoms Progress?

Average progression rates can last years to decades, however, earlier onset disease may manifest much quicker.

The stages of Parkinson’s are illustrated below:

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How is Parkinson’s treated?

Although there is no cure for Parkinson’s, symptoms can be treated by a variety of measures.

  • Levadopa – converts to dopamine in the brain, helping replace the deficient hormone.
  • Carbidopa (Sinemet) – if given with levadopa prevents the latter from being broken down before it reaches the brain.
  • Dopamine agonists – mimic dopamine
  • MAO-B inhibitors – helps block the enzyme MAO-B, which breaks down natural dopamine
  • Other medications including COMT inhibitors, amantadine and anticholinergics
  • Medications to treat anxiety and depression
  • Deep brain stimulation – a surgeon implants electrodes into the brain, allowing stimulation of parts that help regulate movement.
  • Stem cell therapy – being investigated as a means to create dopamine-producing cells
  • Physical and occupational therapy

 

Famous People Diagnosed with Parkinson’s

  • Michael J. Fox
  • Janet Reno
  • Robin Williams
  • Muhammad Ali
  • Casey Kasem
  • Johnny Cash
  • Linda Ronstadt
  • Pope John Paul II
  • Peanut’s creator Charles Schulz
  • Rev. Jesse Jackson
  • Neil Diamond

It’s been postulated Adolf Hitler suffered from Parkinson’s as well.

 

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

Posted in Health, news

New Rare Blood Type Identified

Doctors in India have discovered a man who holds a very rare blood type:  pp (P null).

The patient had needed a blood transfusion and when his sample was “typed and crossed” to find compatibility with 80 different units of blood, the hospital could not find a match.  Further testing was done at the International Blood Group Reference Laboratory (IBGRL) in the UK and the pp phenotype was identified.

Most blood cells fall under the main phenotypes of A, B, AB and O. These are based on antigens located on the surface of the red blood cell.

Those with type A blood have A antigens and antibodies against type B and AB blood.

Conversely those with type B blood will have B antigens and antibodies against type A and AB blood.

Since O blood lacks antigens on its cell, it can be assumed by a patient with any blood type.  Hence those with type O blood are considered to be “universal donors.” However type O blood patients cannot receive blood if it has an A or B antigen.  AB patients can, hence are considered “universal recipients.”

 

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Image from transfusion.com

 

The Rh D antigen is either present or absent thereby rendering a blood type “+” or “-“.  Hence a person with A+ blood will have A antigens, anti-B antibodies and an RhD antigen.

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Giving a person blood for which they have antibodies against will induce a transfusion reaction resulting in the immune system fighting off the blood resulting in worsening anemia.

However there are over 200 minor group antigens other than the ABO and Rh system.  In the patient from India, his blood was found to be “p null” and have anti-PP1Pk antibodies.  He was at risk for having a transfusion reaction if given incompatible blood.  The hindu.com reports: Kiran Acharya, professor of Orthopaedics and his team, performed blood-less surgery (Femur fracture repair) once the patient’s haemoglobin was increased to the desired level using other medications.

A registry for this rare type of blood is now being created in the region now that there appears to be a need.

 

 

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Learning Medical Spanish is Easy!!!

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

Posted in food, Health

The Big Mac Turns 50

This week the iconic McDonald’s burger turns 50.

Created in 1967 by franchisee, Jim Delligatti, the Big Mac launched nationwide in 1968.  Having had two failed names prior, “The Blue Ribbon Burger” and the “Aristocrat”, the Big Mac got its name from 21-year old marketing secretary, Esther Glickstein Rose.  It debuted at Delligatti’s McDonald’s franchise in Uniontown, Pennsylvania for $0.45 in hopes to compete with Bob’s Big Boy’s famous burger. It was a hit.

It was also commercial friendly with its “Two all-beef patties, special sauce, lettuce, cheese….”.  McDonald’s could easily include the Big Mac in their jingles.

In the 1980’s, some marketed it as a nutritious option to fast food, having all four food groups (bread, dairy, meat and vegetables).

What about its special sauce?

According to Wikipedia, the ingredients had been well-known for some time, being leaked online years prior and consisting of, “store-bought mayonnaise, sweet pickle relish and yellow mustard whisked together with vinegar, garlic powder, onion powder and paprika.”

To celebrate its 50th anniversary, McDonald’s is launching the MacCoin in 14,000 of its stores.

 

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This new form of brass-colored currency commemorates what would have been Jim Delligatti’s 100th birthday and will award a lucky customer with another Big Mac between now and the end of 2018.

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

Posted in Health, news

Benzodiazepine Abuse Being Overlooked

While the country struggles to fight the opioid epidemic, we may be overlooking the high use and abuse of benzodiazepines.

Benzodiazepines “Benzos” fall under a class of medications used for anxiety, insomnia, and mood disorders.  Their brand names include Xanax, Valium, Klonipin, Ativan and the generic names all end in “am” such as diazepam, clonazepam, and alprazolam.

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Similar to opioids, benzos are considered controlled substances by the DEA and require a prescription to be dispensed.  They are highly addictive and can cause very uncomfortable withdrawals.  But unlike opioids, benzo withdrawal can be deadly.  Some may suffer seizures when they miss their dose, and in the medical field we never recommend abrupt withdrawal of a treatment involving benzodiazepines.

Symptoms of benzodiazepine withdrawal include:

  • anxiety
  • insomnia
  • restlessness
  • heart palpitations
  • headaches
  • tremors
  • nausea
  • inability to concentrate
  • hallucinations
  • psychosis
  • seizures

 

This class of medication has worried providers for decades.  We hesitate prescribing benzos to women of childbearing age as it can cause severe fetal defects if one takes it while pregnant.  Moreover, its interaction with alcohol, opioids, and recreational drugs could enhance one’s risk of inebriation, somnolence and respiratory depression.

The typical benzodiazepine is prescribed as “one pill every eight hours as needed prn (for) anxiety.”  However, I never wrote the prescription in this fashion as I didn’t want patients driving during the day while taking this medication.  So I would instruct them to only take at bedtime or once as needed if they were to be home and in bed.  And if anxiety was an all day issue we add therapy to the treatment plan.

According to BachHuber et al 31% of fatal overdoses that occurred in 2013 involved a benzodiazepine.

And benzodiazepine prescriptions are exponentially rising as patients have difficulty filling opioid prescriptions.  “Sleeping it off” is turned to as a means to battle pain if one cannot obtain adequate pain control.

Moreover our anxiety, impatience, and insomnia is rising as our addiction to computers, the internet and smartphones skyrocket.

This vicious cycle puts our country at risk for another epidemic of a dangerous, addictive and lethal-if-abruptly-discontinued, drug.

It’s time we address the underlying causes of pain, anxiety and addictive behaviors rather than limiting the prescribing power of medical providers.  Patients need help and if they can’t receive it through one modality they will search for other means.  Benzos provide an inexpensive way to relax, sleep and manage pain, but can be in fact more dangerous than the opioids and drugs we are trying to limit.

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

Posted in Health, news

Hot Water Challenge is Deadly and Unfortunately Going Viral

After successfully battling the Tide Pod Challenge and the Condom (through the nose) Challenge this year, we now face another dangerous prank:  The Hot Water Challenge.

There are two ways one participates in this one:

  1. Having boiling water poured on oneself
  2. Drinking boiling water from a straw

Both expose the victim to severe burns, putting them at risk for infection, dehydration, breathing difficulties and shock.

In July an 8 year old girl, Ki’ari Pope, died after burns in her mouth and throat left her unable to breathe.  Then last week, and Indianapolis teenager, Kyland Clark, participated in the challenge after he and his friend watched the pranks on You Tube.  He suffered multiple second degree burns on his chest and face.

 

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Challenges that involve dangerous stunts have been around for years.  The Choking Challenge induced children to suffocate themselves for the high of feeling asphyxiated.  The Tide Pod Challenge tempted kids to put colorful cleaning packets in their mouths, hoping they wouldn’t burst.

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The Cinnamon Challenge sparked thousands to inhale the common kitchen spice and cough till they puked.  Then the Condom Challenge offered two options where one dropped a condom filled with water on a friends face, or snorted one through the nose.

 

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We adults can’t for the life of us figure out what the reward is in performing these challenges, but presume its fame and awe among friends and social media followers.  But these challenges prove dangerous and in some cases deadly.  Unfortunately the YouTube Clips never show the after effects of these pranks…maybe they should.

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

Posted in food, news

Canter’s Deli in West Las Vegas Closes in Under a Year

The long-awaited famous deli which opened in West Las Vegas in September of 2017 closed its doors last week.

According to vegas.eater.com, Canter’s Deli was booted due to failure to pay the rent. They report the general manager of Tivoli Village, Philip Knott, ended their agreement with Canter’s due to “lack of payment of rent over last four months and poor management of the operation. Canter’s was targeting to be turning a revenue of over $2 million in its first year on site, yet repeatedly failed to live up to its obligations leaving the landlord no option but to begin with the removal process this weekend. We look forward to welcoming better operators with higher standards and a better fit for Tivoli Village.”

Those of us from Los Angeles, who long knew the original Canter’s, are not surprised.

The Fairfax “Jewish Deli” was a local favorite for decades, so when those of us in Vegas learned of its opening, we lost our bagels.

 

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However, upon dining at the desert restaurant, we were disappointed to say the least.

In my first visit I sat down at the booth, mouth-watering for some of their famous Latke’s (potato pancakes) only to learn that they didn’t have any that day.

So I ordered some chicken salad and blamed my taste buds for confusing it with stale tofu.

So I returned a second time to order latkes and they barely resembled the Los Angeles masterpiece.  I concluded they were making hockey pucks instead to honor the Vegas Golden Knight’s.

 

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How I want my latkes to look

 

But this is where they failed.  The oringial Canter’s bakery is a smorgasbord of delectables.

 

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The Las Vegas location’s bakery, however, was anemic on its best day.  Cookies were dry and hard and there was no variety offered, making it the least likely place one would go to buy a babka or rugelach.

A local deli implies one can stop in, order goodies to go, and leave happy carrying two big brown paper bags. And a deli’s display case and walk up counter need to look like this:

 

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The original Canter’s opened in 1931 in Boyle Heights, and later moved to Fairfax in 1953.  It’s still owned and operated by the Canter’s family.

 

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Their matzoh ball soup, although not the most aesthetic, tastes exactly as it should, and as a young girl, it was mom’s go-to medicine for my sore throat, cough, or menstrual cramps.

Chicken Soup works better than medicine.

The Tivoli Village location, however, was not owned by the Canter’s family, but by Kevin Jeffers, and to his credit the bagels, cream cheese, and decor were spot on.

However, some delicatessens can’t be reproduced, so my suggestion is to not even try.  The Bagel Cafe still holds the rank as top delicatessen in Las Vegas and some would argue we need more.  So a fresh new deli that makes the best matzoh ball soup this side of the San Andreas could work……. but don’t call it Canter’s if it’s not.

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

Posted in Health, news, sex

CDC Reminds us NOT to Wash Used Condoms

If you thought the “Wear A Seatbelt” campaign was recommending the obvious, now comes the “Throw Out Your Used Condom” campaign.

This week the CDC urged Americans in a tweet to “not wash or reuse condoms.”

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If used correctly, condoms offer 98% protection against unwanted pregnancy.  STD protection varies as some skin on skin contact can transmit viruses such as HPV and herpes.

According to a study published in the Journal of Sexual Health (reported by NBC News),  between 1.4 percent and 3.3 percent of respondents had re-used a condom at least twice during a sexual encounter.

Key phrase: At least twice….

Condom prices average between $0.50 – $1.00 a condom, and many clinics and health departments dispense them for free.

Condoms may leak, slip off or break rendering them useless, hence new, unused condoms offer the best chance of success.

The History of the Condom

Although the first “rubber” as we know it was developed in the 1850’s, thanks to Charles Goodyear and the vulcanization of rubber, prophylactics were created in all shapes and sizes for centuries.

Materials included tortoise shells, sheep intestine, animal bladders, horns, silk and even gold.

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allthatinteresting.com: A rare Glan condom from Asia Minor created during the Bronze age and made of silver and gold.

Around the 16th century the deadly STD, syphilis, began to spread rapidly and Gabriele Fallopio devised a linen sheath to be tied onto the penis.  When tested on 1,100 men none contracted syphilis.  His name, ironically, is carried by women who still have their fallopian tubes.

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Condom from the 1600’s

Following this period, condom use became controversial as some believed it promoted immoral behavior. Animal skin then became a popular material, but users complained of the condom falling off.

When Charles Goodyear patented the vulcanization of rubber the first condom as we know it was created in 1855.  Vulcanization is the heating of rubber with chemicals such as sulfur, making it stronger and more elastic.

By the 1950’s Durex added lubrication to the condom and by the 1980’s spermicidal gel was included.

How to use a condom correctly

Again condoms should never be reused and the following should be ensured to make sure they provide adequate protection:

  1. Always inspect the condom first for breaks, leaks, and tears.
  2. Unroll the condom before putting it on.
  3. Make sure there is some space at the tip, allowing room for semen
  4. Put the condom on before intercourse
  5. Leave the condom on until after intercourse
  6. Do not reuse or turn it inside out

 

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada