Posted in Health, news, Politics

Senator John McCain Diagnosed with Brain Tumor

Last week, when we were told Senator John McCain (R-AZ) was being treated for a blood clot above his left eye, we suspected a tumor could have been involved, as he was a cancer survivor and tumors are thrombogenic, meaning clot forming.

Unfortunately, the 80 year old melanoma cancer survivor has been diagnosed with primary glioblastoma.  However, its been reported that the whole tumor was removed when the doctors performed a craniotomy (opening of the skull) to remove the blood clot.  A statement from his office reports Senator McCain is home and recovering “amazingly well”.

What is Primary Glioblastoma?

Primary Glioblastoma Multiforme is a type of brain tumor that arises in the brain and spinal cord and is very aggressive in nature.  “Primary” suggests the tumor is not secondary to another cancer, such as the melanoma Senator McCain successfully battled.

In 1993, 2000 and 2002, McCain had three malignant melonama lesions removed, and the 2000 lesion was close to his left temple.

Those diagnosed with a glioblastoma may have a poorer prognosis  compared to other cancers as the 5-year survival rate is only 10%.  Its median survival is less than 15 months.  However, with his lesion removed, and chemotherapy and radation set to begin once his incision has healed, many medical teams are optimisitc.

According to his daughter, Meghan McCain, her father is “confident” and “calm”.  CNN reports that when the Senator awoke from surgery he was “cracking jokes” and ready to go home and get to work.

This is a developing story.

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

Posted in Health, news, Politics

The Presidents and Their Medical Issues

 It’s been long postulated that JFK could have survived if he wasn’t wearing his back brace the day he was shot.  President Kennedy suffered from many issues including Addison’s disease and multiple back surgeries.  His brace possibly kept him upright when the first shot hit, whereas he could have slumped over and been out of the line of fire during the second shot.

The medical issues plaguing our Presidents used to be kept secret, a luxury current politicians can’t fathom in today’s media world.  Each President faced insurmountable tasks on national and global levels.  Let’s now take a look at what our leaders battled personally.

Updated 7/11/17

George Washington – I cannot tell a lie….

It is believed that George Washington suffered from diphtheria, tuberculosis, malaria, smallpox, dysentery, possible sterility, tonsillitis, and epiglottitis.  He appeared to have  many issues with the back of his throat.  Syphilis has been debated but then again many people at the time had syphilis (Abraham Lincoln supposedly had syphilis when he was younger).

George Washington had one original tooth left by the time he became president.

His teeth were not made of wood…..instead made of hippopotamus/walrus/elephant ivory or transplanted teeth.

The tooth loss could have been from the mercury oxide that was used to treat his smallpox and malaria.

During one of his battles its been said he had to ride with a pillow on his saddle while being ill with fever.  It is believed that the dysentery left his bottom in so much pain that he required a pillow on which to sit.

In 1799, George Washington died of presumed epiglottitis, sore throat, and difficulty breathing.  His end was a painful one as doctors burned and blistered him to draw out the humors.

James Garfield – “Did the doctors kill this President”

James Garfield was shot twice (once in the arm and once in the back) on July 2, 1881.  The bullets and wounds supposedly were not lethal but the un-sterile technique used (the practitioners used their fingers to find the bullets while he lay at the train station) caused him to have an infection and his doctors supposedly restricted his eating since they thought the bullet pierced the bowel.

They fed James Garfield by rectal enema.   He was fed beef bouillon, egg yolks, milk, whisky and opium through his rectum.  It was considered a “nutritional enema”.

Interestingly, Alexander Graham Bell devised a metal detector made of a battery and several metal coils positioned on a wooden platform, connected to an ear piece to help find the bullet.  Unfortunately, the attempt was unsuccessful. James Garfield died 80 days later.

Thomas Jefferson – ahead of his time…….

Thomas Jefferson lived until he was 83.  He was not a vegetarian but ate less meat than others and increased his vegetable intake.

His sleep habits were also good – 5-8 hours of sleep in a “reclined” position.   “Whether I retire to bed early or late, I rise with the sun.”

He was against tobacco, and moderately used alcohol. “…you are not to conclude I am a drinker. My measure is a perfectly sober 3 or 4 glasses at dinner, and not a drop at any other time. But as to those 3 or 4 glasses I am very fond.”

Its been postulated he also had Aspergers…….

 

William Taft –  Poster child for sleep apnea and the “Atkins diet”.

 President Taft weighed over 300 lbs and supposedly would nod off during the day and during meetings with world leaders.  It was therefore presumed he had narcolepsy, most likely a result of his sleep apnea.

His doctor put him on a low carb diet and he lost 60 lbs.

 

Franklin D. Roosevelt –  as if polio wasn’t enough…..

In addition to being a victim to polio, cerebral hemorrhage and very high blood pressure, its been postulated that FDR had malignant melanoma above his left eyebrow….possibly the cause of his hemorrhage when it spread to the brain.

fdr

Abraham Lincoln – was he suicidal?

Firstly, lets discuss the myth that Abraham Lincoln had Marfan’s Syndrome.  We now understand he didn’t but actually had a genetic disorder, MEN2B  which gave him a Marfanoid appearance (tall, lanky, long limbs), large lower lip, history of constipation, bumpy lips, “pseudodepression”, and his mother possibly suffered the same disorder.

Was Lincoln suicidal?  The poem, Suicide’s Soliloquy was believed to be authored by Abraham Lincoln.

Why did it take Abraham Lincoln 11 hours to die from his fatal wound? ……Doctors actually relieved the intracranial pressure, and appeared to do an amazing job considering the time.  Unfortunately he fell unconscious immediately, and they never were able to revive him.

Woodrow Wilson – Was he always in charge?

In October of 1919, Woodrow Wilson suffered a stroke.  After his medical incident its believed his wife Edith ran the country while he was bedridden.  He died in 1924, three years after leaving office at the age of 67.

 

Dwight D. Eisenhower – if your heart’s not in it…..

 

In 1955 he suffered a myocardial infarction (heart attack). He originally thought he suffered from indigestion.  Recovery time was much slower than modern day and he was kept on bed rest for months.  He was considering resigning.  Months later he regained his strength and successfully ran for a second term.

 

John F. Kennedy – did his back brace kill him?

Why was JFK so “tan”? He suffered from Addison’s disease and along with this suffered from chronic back problems.  He required  multiple injections and medicines on a routine basis after a series of failed back surgeries.

His back brace may have cost him his life……Historians believe he didn’t slump over after the first shot (prevented by the brace) and was therefore sitting upright when the second shot hit his head.

jfk-slump

JFK appears to be in his back brace that day.  If the first shot caused him to fall over, historians believe he could still be alive today, avoiding the second fatal shot to his head.

 

Other reported maladies affecting some U.S. Presidents include:

Ulysses S. Grant – throat cancer

Chester Arthur – Bright’s disease

Teddy Roosevelt – detached retina

Herbert Hoover – GI Cancer and GI bleed

Richard Nixon – phlebitis, blood clots

George HW Bush – hyperthyroidism/Graves disease

In short, Presidents are not always in the finest of health and may suffer the same maladies their constituents do.  Washington has always found a way to keep this from the public and may continue to despite today’s technology.

 

 

 

                                                                                                       LearnHealthSpanish.com

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

Posted in Health, news, Politics

Senate Reveals Their Version of the Healthcare Bill

Senator Mitch McConnell (R-KY) revealed the Senates version of the repeal and replacement bill of the Affordable Care Act, The Better Care Reconciliation Act of 2017.

On the Senate floor McConnell stated their plan would specifically do the following:

Repeal Individual Mandate

Repeal Employer Mandate

The text of the draft was to be made available soon, addressing the following:

Repeal of Tax on Health Saving’s Accounts

Repeal Tax on prescription medications

Repeal Medical Device Excise Tax

Repeal Chronic Care and Health Insurance Tax

Repeal Tanning Tax

Repeal Medicare Tax Increase

Redefine Federal Payments to the States

Redefining Medicaid Expansion

Reducing state Medicaid costs and allowing waivers to give states more options to allocate funds to where they have the greatest medical needs.

Establishment of a Prevention and Public Health Fund

Maintain protections for those with pre-existing conditions

Allow children up to the age of 26 to stay on their parent’s insurance plan.

Differences between the Senate and House bill

The Senate Bill will continue the Medicaid expansion until 2021 before phasing it down over three years, as opposed to the House version, which limited new enrollee funding in 2020.

Moreover those earning 400% above poverty level would not qualify for premium subsidies, being lowered to a 350% threshold.

The CBO is expected to release their analysis of the 142 page bill and score of the Senate revised bill by next week.  The Senate would then be expected to debate the bill after that.

The full draft of the Senate Bill is included here: Senate Health Care Bill

This is a developing story.

                                                                                                       LearnHealthSpanish.com

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

Posted in Health, news, Politics

Rep. Scalise in Critical Condition: What is “Critical”?

Image above from Essdras M Suarez/Zuma Press

Updated 6/14/17 20:12

Wednesday morning, Rep. Steve Scalise and 5 others were gunned down during a baseball practice at the Eugene Simpson Stadium Park in Alexandria, VA while they were prepping for a charity event that was to be held the next day.

Reports say Rep. Scalise was “shot in the hip”, but had been stable upon initial treatment in the hospital.  MedStar Washington Hospital Center at approx. noon PT, tweeted that the House Majority Whip  “was critically injured and remains in critical condition.”

In the evening, MedStar stated the following, “Congressman Steve Scalise sustained a single rifle shot to the left hip. The bullet traveled across his pelvis, fracturing bones, injuring internal organs, and causing severe bleeding. He was transported in shock to MedStar Washington Hospital Center, a Level I Trauma Center. He underwent immediate surgery, and an additional procedure to stop bleeding. He has received multiple units of blood transfusion. His condition is critical, and he will require additional operations. We will provide periodic updates.”

 

___________________________________________________________________________________________

6/14/17 12:30

 

Rep. Mo Brooks who was at the scene, removed his belt to apply tourniquet pressure to Rep. Scalise’s leg.  This implies heavy bleeding was occurring and witnesses state Scalise, after he was shot, tried to drag his body away from the shooter, leaving a trail of blood behind.

Sen. Rand Paul and Rep. Brad Wenstrup also administered first aid to the victims.

The victims, including Scalise, were:

Zachary Barth:  Shot in the leg, expected to recover. Serves as Congressional staffer for Rep. Roger Williams.

Matt Mika:  reportedly shot multiple times, currently having surgery and in critical condition.  Serves as a lobbyist and Tyson Foods employee.

David Bailey and Krystal Griner – the US Capitol Police who exchanged gunfire with the gunman and were wounded in the process.  Its been reported they are in stable condition.

The 66 year old gunman, James T. Hodgkinson, was shot, and taken into custody.  He has since died of his injuries.

Many are relieved the heroic Bailey and Griner are both in “stable condition”, but deeply concerned about those in “critical condition.”  Let’s break down what these descriptors mean:

“Conditions” are based on vital signs (heart rate/pulse, blood pressure, respiratory rate, oxygenation) and a current medical “picture”.  According to the American Hospital Association Guidelines these are divided into:

Undetermined: Patient awaiting physician and assessment.

Good: Vitals signs are stable and within normal limits. Patient is conscious and comfortable. Indicators are excellent.

Fair: Vital signs stable and within normal limits. Patient is conscious, but may be uncomfortable. Indicators are favorable.

Serious: Vital signs may be unstable and not within normal limits. Patient is acutely ill. Indicators are questionable.

Critical: Vital signs are unstable and not within normal limits. Patient may be unconscious. Indicators are unfavorable.

However this causes confusion as many ask how one could be “critical AND stable”??

In medical settings, we say someone is “stable” when their condition is not worsening.  Its a calming descriptor allowing families and friends to take a deep breath and know their loved one is not on the verge of death.

A stable patient, however could be critically injured and need intensive care.  One could be stable coming out of surgery, but become unstable if an unfortunate medical incident occurs afterwards.

“Critical” specifications are given to those whose injury could have been life threatening and who needs to be monitored and tended to continuously.  One may remain stable during this time.

This is a developing story:

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

 

 

 

Posted in Health, news, Politics

Medical Students Find and Fix Flaw in Impaired Driver Testing for Marijuana

Multiple states in the US currently allow recreational marijuana or medicinal use of cannabis and multiple more states may be following suit in upcoming elections.

Even those who support the legalization have concerns over driver safety and how to determine if one is impaired.

Breathalyzers are currently being developed and tested but are not ready for roadway spot checks.  Moreover, breathalyzers may have difficulty accurately detecting both inhaled and ingested marijuana.

California law enforcement officers are piloting road-side saliva tests but objective data is still lacking regarding the accuracy of oral fluid tests.

Currently when law enforcement tests an impaired driver for marijuana use, a urine test can be performed which only looks for a metabolite called THC-COOH.    Despite its abbreviation it is a non-psychoactive component of marijuana, as opposed to delta-9-tetrahydrocannabinol (delta-9-THC), which does cause euphoria.  Hence the shortcoming to this testing method are two-fold, as the non active THC-COOH isn’t even the correct metabolite to measure intoxication and it can linger in the body for weeks, hence not allowing an adequate quantitative measure to determining one’s impairment.

Two medical students, however, figured out what needs to be tested and how.  Graham Lambert and Charles Cullison, both entering their third year at Touro University Nevada, performed research for an American College of Legal Medicine (ACLM) poster contest.

One of the lead researchers and osteopathic medical student Graham Lambert said, “This is an issue because it’s non-psychoactive. It stays in the body for long periods of time, long after any psychoactive effects.” Their research lead them to conclude that testing should instead look for an alternate THC metabolite, 11-OH-THC.

Why?  Let’s break this down.  Now both delta-9-THC and 11-OH-THC are psychoactive compounds that can be tested in the blood.  However law enforcement has to determine whether euphoria was present and a factor in one’s unlawful driving.  Both delta-9-THC and 11-OH-THC crosses the blood brain barrier, a semipermeable endothelial cell barrier that helps decide what substances can enter and leave the brain.  But 11-OH-THC’s is more readily active and can bind to the brain’s cannabinoid receptors tighter, lasting longer and causing more of a psychoactive effect.

Additionally, 11-OH-THC is a metabolite also seen in high quantities after ingesting marijuana edibles.

Metabolism-THC-T.png

Image from sapainsoup.com

 

In 2012, Sharma et al found the 11-OH-THC to last twice as long in the blood than delta-9-THC, which would make sense due its strong binding properties.  Yet the psychoactive 11-OH-THC will rapidly be metabolized to an inactive form hence its presence on a test will signify activity rather than just “hanging around”.

Once Lambert and Cullison determined this, they went to Assemblyman Steve Yeager, D-Las Vegas, who is Chair of the Assembly Judiciary Committee.  Yeager helped sponsor a bill, AB135 that would convert marijuana testing for drivers from the inaccurate urine test to a blood test that would look for specifically 11-OH-THC.

Also lead researcher and osteopathic medical student, Charles Cullison said, “Blood alone accurately shows the levels of hydroxy (11-OH-THC) and marijuana.”

In regards to getting the bipartisan law passed through the State Senate with a “Veto-less” majority,  Cullison stated, “We couldn’t have done this without the help of many people.”

After Nevada lawmakers passed AB 135, Governor Brian Sandoval signed it into law. The antiquated urine testing will not be used to test drivers pulled over for possible DUI but a blood test instead.

DSCN1283 (2).JPG

Clockwise:  Assemblyman Steve Yeager, DO student Graham Lambert, DO Student Charles Cullison, Governor Brian Sandoval

 

The legal limit of marijuana that is measured in nanograms per milliliter ng/ml would be 2 ng/ml for delta-9-THC and 5 ng/ml for 11 Hydroxy-THC.  This does not change with passage of AB135, nor do the circumstances surrounding when to test, as current protocols are in place once a person fails his sobriety test.

 

 

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

 

 

 

Posted in Health, news, Politics

CBO Score on American Health Care Act is in

The CBO, Congressional Budget Office, gave their analysis of the recently House-passed bill aiming to repeal and replace Obamacare, the American Health Care Act (AHCA).

The most recent report found that the AHCA would

  • reduce the deficit by $119 million
  • cost 23 million Americans to lose their coverage by 2026
  • lowers premiums from current Obamacare/ACA prices

52752-land-figure1.png

The bill needs to be approved by the Senate.  In order for it to pass it needs to  comply with the following:

– Not increase the federal deficit beyond a 10 year window

– Save at least $2 billion dollars as overseen by the Senate Finance Committee and the Senate Health, Education, Labor, and Pensions Committee.  If so, this allows Republicans to use budget reconciliation, a budgetary rule that enables them to avoid a Senate Democratic filibuster and pass their bill with only 51 votes rather than a 60 vote majority.

– not cause “millions” of Americans to “lose” their healthcare.

The last CBO analysis of the AHCA found it to potentially cause 24 million Americans to lose coverage, a point debated as Medicaid expansion and federal funds were to slowly regress as the economy improved.

Capitol-home-4_1.png

The CBO also estimated that insurance premiums would RISE 750% with the previous GOP version to repeal and replace Obamacare. This plan appears to LOWER insurance premiums.

Before amendments needed to be made to ensure passage, the original AHCA wanted to implement the following :

  1. Eliminate the tax penalties, “individual mandate” and “employer mandate” imposed on those who don’t purchase health insurance for themselves or employees.
  2. Tax credits will be based on age rather than income ranging from $2000/year for those younger than 30 to $4,000 a year to those who are older than 60. A family would receive up to $14,000 in tax credits a year. These tax credits would start phasing out when income becomes  $75K individually or $150K as a family. For every $1,000 in earnings above those thresholds, the value of the credit phases down by $100.
  3. Allow insurance companies to charge a 30% surcharge to those who have gaps in insurance longer than 63 days.
  4. Maintain coverage, preventing denial, to those with pre-existing conditions
  5. Maintain coverage for children under age 26 who wish to stay on their parent’s plans.
  6. Maintaing the bans on caps on annual or lifetime coverage
  7. By 2020, ACA promised federal funds for Medicaid expansion will stop.  Funds will continue for current Medicaid recipients
  8. Create a Patient and State Stability Fund, which provides states $100 billion to use as they wish for their underserved populations, hospitals, providers or programs that would provide direct care.
  9. States will receive money for Medicaid in a lump sum per person rather than an open-ended promise of funds.
  10. Taxes on medical device industry will expire as will those on pharmaceutical companies and indoor tanning services.
  11. Planned Parenthood is “defunded” as AHCA funds cannot be used to pay for services at their clinics.
  12. HRA increase – starting in 2018 individuals could contribute pretax dollars to their Health Savings Account up to $6550 individually and families up to $13,100.

For more on the CBO analysis, read here:  https://www.cbo.gov/publication/52752

                                                                                                       LearnHealthSpanish.com                                                                                                         Medical Spanish made easy

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

Posted in Entertainment, Health, news, Politics

Fox News Founder, Roger Alies, dies at age 77

Three days after his 77th birthday, Roger Alies died Thursday morning. The cause of death is unknown.

The former chairman of Fox News allegedly suffered a fall 8 days prior at his Florida home. On Wednesday TMZ reported his condition was worsening as he became unconscious and comatose Wednesday night.

His wife released the following statement, “I am profoundly sad and heartbroken to report that my husband, Roger Ailes, passed away this morning.”  “Roger was a loving husband to me, to his son Zachary, and a loyal friend to many. He was also a patriot, profoundly grateful to live in a country that gave him so much opportunity to work hard, to rise—and to give back. During a career that stretched over more than five decades, his work in entertainment, in politics, and in news affected the lives of many millions. And so even as we mourn his death, we celebrate his life.”

The founding CEO of Fox News Channel resigned last summer in the wake of numerous sexual allegations.

Prior to launching Fox News in 1996, he was an adviser to Presidents Richard Nixon, Ronald Reagan and George H. W. Bush and helped launch and head CNBC.

This is a developing story.

                                                                                                       LearnHealthSpanish.com                                                                                                         Medical Spanish made easy

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician