Posted in Health, Politics

President Trump’s Physical and Mental Health Exam Results

White House Physician, Navy Rear Adm. Dr. Ronny Jackson, performed President Donald Trump’s annual physical last week are released the following results:

From Politico:

President Donald J. Trump has completed his first periodic physical examination as President of the United States. I performed and supervised the examination with appropriate specialty consultations and diagnostic testing. The exam was conducted January 12, 2018 at the Walter Reed National Military Medical Center.

The purpose of this exam was to provide the public with an update of the President’s current health status and to ensure the President continues to enjoy all the benefits of good health. This examination focused on evidence-based health screening and disease prevention.

With President Trump’ s consent, I release the following health information:

Vital Statistics
Age: 71 years, 7 months
Height: 75 inches
Weight: 239 pounds 
Resting heart rate: 68 bpm
Blood pressure: 122/74 mm 
Hg Pulse-oximetry: 99% room air 
Temperature: 98.4 degrees F

Physical Examination by System (to include studies)
Eyes: Uncorrected visual acuity was 20/30 bilaterally, with corrected visual acuity of 20/20 bilaterally. Visual fields were normal. Fundoscopic exam was normal bilaterally. Intraocular pressures were normal bilaterally. No ocular pathology was discovered.

Head/Ears/Nose/Throat: Normal exam of the head, ears, nose, mouth, and throat.

Dental: Healthy teeth and gums.

Neck: Normal thyroid exam. No noted lymphadenopathy. Auscultation of the carotid arteries normal.

Pulmonary: Lungs clear to auscultation. A screening Low Dose CT of the chest demonstrated no pulmonary pathology.

Cardiac: Heart exam normal. Regular rhythm. No murmurs or other abnormal heart sounds noted. ECG with normal sinus rhythm, rate of 71, normal axis, and no other significant findings. Transthoracic Echocardiogram demonstrated normal LV systolic function, EF 60-65%, normal LV chamber size and wall thickness, no wall motion abnormalities. RV normal, atria grossly normal, all valves normal. Exercise Stress Echocardiogram demonstrated above average exercise capacity based on age and sex, and normal heart rate, blood pressure, and cardiac output response to exercise. No evidence of ischemia noted and wall motion was normal in all images.

Gastrointestinal: Normal exam. No masses, hepatomegaly or splenomegaly noted. Normal optical colonoscopy with no polyps or abnormal findings completed June 2013. Repeat colonoscopy not indicated and was deferred until next periodic physical exam.

Genitourinary: Normal exam.

Extremities/Musculoskeletal: Normal throughout. Full range of motion in all joints. Strong distal pulses and good capillary refill in all extremities. No swelling or edema noted.

Neurological: Examination of cranial nerves, cerebellar function, deep tendon reflexes, motor function, and sensory system all normal. Cognitive Screening Exam using the Montreal Cognitive Assessment was normal with a score of 30/30.

Dermatologic: Normal exam. No evidence of melanoma , basal cell carcinoma, squamous cell carcinoma, or any other significant dermatologic disease.

Laboratory Results
Lipid Panel: 
Total cholesterol: 223 (mg/dL)
Triglycerides: 129 (mg/dL)
HDL cholesterol: 67 (mg/dL)
LDL cholesterol: 143 (mg/dL)
Cholesterol to HDL ratio: 3.3

Complete Blood Count: 
WBC: 5.5 (K/UL)
HGB: 16.1 (g/dL)
HCT: 48.7 (%)
PLT: 241 (K/UL)

Extended Metabolic Panel: 
Fasting Blood Glucose: 89 (mg/dL)
BUN: 19.0 (mg/dL)
CREAT: 0.98 (mg/dL)
ALT: 27 (U/L)
AST: 19 (U/L)
Hemoglobin AlC: 5.0 (%)
Vitamin D: 20.0 (ng/ml)
PSA: 0.12 (ng/ml)
TSH: 1.76 (ulU/ml)

Urinalysis: 
Appearance: Clear
Protein: Negative
Ketones: Negative
Glucose: Negative
Blood: Negative

Past Medical History
• Hypercholesterolemia 
• Rosacea

Past Surgical History 
Appendectomy (age 11)

Social History
• No past or present use of alcohol. 
• No past or present use of tobacco.

Medications
Rosuvastatin (Crestor), 10 mg daily to lower cholesterol.
Acetylsalicylic Acid (Aspirin), 81mg daily for cardiac health.
Finasteride (Propecia), 1 mg daily for prevention of male pattern hair loss.
Ivermectin Cream (Soolantra), As needed for treatment of Rosacea
Multi-vitamin (Centrum Silver), Daily for overall health maintenance.

Immunizations
• Prevnar 13 (to prevent pneumococcal pneumonia) and Twinrix (to prevent hepatitis A/B) given. 
• Routine vaccinations, to include seasonal influenza, all up to date.
• All indicated travel vaccinations up to date.

Summary
The President’s overall health is excellent. His cardiac performance during his physical exam was very good. He continues to enjoy the significant long term cardiac and overall health benefits that come from a lifetime of abstinence from tobacco and alcohol. We discussed diet, exercise and weight loss. He would benefit from a diet that is lower in fat and carbohydrates and from a routine exercise regimen. He has a history of elevated cholesterol and is currently on a low dose of Rosuvastatin. In order to further reduce his cholesterol level and further decrease his cardiac risk, we will increase the dose of this particular medication. The President is currently up to date on all recommended preventive medicine screening tests and exams.

All clinical data indicates that the President is currently very healthy and that he will remain so for the duration of his Presidency.

President Trump is in “excellent health.”

At the above height and weight, Donald Trump’s BMI is 29.9 placing him in the overweight category just shy of the 30 BMI cut off for obesity.

His blood pressure and heart rate are excellent for his age, especially in the absence of a blood pressure medication.

His pulse oximetry demonstrating the oxygenation of his blood is excellent as well.

An uncorrected vision test of 20/30 means that without glasses, the president has near perfect vision.

A low dose CT of the chest is not routine during annual physicals in non-smokers, but is reassuring that he most likely doesn’t suffer from lung cancer, the number one cancer killer in America.

His EKG, which evaluates electrical abnormalities of the heart secondary to disease or heart attack, confirmed the ideal heart rate.

His echocardiogram, and ultrasound evaluating heart structures and pump activity, demonstrated no heart failure or issues with the filling or pumping of blood, as well as confirming normal anatomy (valves, wall thickness, etc).

A stress test evaluates for cardiac ischemia, or loss of blood flow to heart muscle during rest and exercise, and was normal as well.

A normal colonoscopy in 2013 suggests his next screening colonoscopy wouldn’t be performed until 2023 unless he had pain, rectal bleed, changes in his stool, or any risk factors for colon cancer.

The Montreal Cognitive Assessment was given to evaluate cognitive function and is not routinely done during annual physicals.  This was performed and passed with a 30/30 score.  The test evaluates memory, orientation, visuospatial and executive brain function, recal, concentration and language fluency.  An example is shown here.

His cholesterol is elevated but his good cholesterol is strong and his ratio of cholesterol to HDL is well within goal.

cholesterol-levels-chart

The remaining blood tests looked very good, especially his HBA1C and blood glucose evaluating for diabetes.

Of note is his Vitamin D level which appears low-normal and could put him at risk for osteoporosis.  It does not appear a bone density test, Dexa scan, was performed.

A PSA of 0.12 is reassuring as well although is not recommended as a screening test for prostate cancer.

Its been suggested that President Trump loses 10-15 lbs and increases his excercise activity.

My opinion, for a 71-year-old man with high cholesterol, President Trump is way ahead of the curve.  I’m a fan of Crestor, his cholesterol lowering mediation, and credit his lipid profile numbers to his use of the statin.  His weight is an issue but I think the White House has a bowling alley, chefs who could make asparagus taste like meat, and secret service who wear fitbits.  I think he’ll be just fine.

This is a developing story.

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

 

 

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Posted in Health, news, Politics

Controlled Substance Prescribing in Nevada – What Does AB 474 Mandate?

In response to the rising opioid death crisis, Nevada lawmakers passed AB 474, which goes into effect January 1, 2018, to help curb overprescribing of narcotics. Although some hail it as a long-overdue measure to limit narcotic prescriptions, many medical providers and patients worry it will severely limit patient access to controlled substances.  Here’s the breakdown.

Chambers2.jpg

Summary of Assembly Bill 474

Providers will be required to report cases or suspected cases of drug overdose.  Failure to do so will be considered a misdemeanor.

Providers will be required to add additional information to the state’s Prescription Drug Monitoring Program (PDMP) for those requiring a controlled substance including the patient’s medical diagnoses and the least number of days the medication will be necessary.

Providers will be required to maintain proof that they have access and use the PDMP prior to their registration or renewal of license to prescribe a controlled substance.

Licensing boards will have the authority to obtain medical records and investigate any activity deemed fraudulent, illegal, unauthorized or inappropriate prescribing and impose disciplinary action if a violation has occurred.

Prescribers will have to increase their training to 2 hours in the subjects of abuse and misuse of controlled substances as well as prescribing of opioids.

Providers will have to document why the patient is needing the controlled substance and justify the quantity written.

Providers will need to obtain written consent by the patient as well as develop and document an evaluation, risk assessment and treatment plan prior to initiating the prescription for the controlled substance.

If the prescription will be a 30 day supply, a written agreement needs to be created between doctor and patient.

The State Board of Pharmacy will have the authorization to enforce provisions of the bill resulting in disciplinary action of the medical provider who violates the provisions or prescribes a controlled substance “inappropriately”.

Providers will be required to, every 90 days, obtain a patient utilization report created by the Board and the Investigation Division while the patient is being prescribed the controlled substance.

What are the Controlled Substances being referred to?

Medications are classified based on their abuse potential, safety profile and medical applications.

USP1310-CE-T2.gif

AB 474 refers to Schedule II, III and IV class drugs. These are broken down, according to the Controlled Substance Act, as the following:

Schedule II Drugs

Schedule II drugs have a high potential for abuse, and if abused may lead to severe psychological or physical dependence.

Some of these include:

  • Adderall
  • Ritalin
  • Hydrocodone, as used in Vicodin and Lortab
  • Oxycodone, as used in Percocet, Oxycontin
  • Percocet
  • Morphine
  • Oxymorphone
  • Demerol
  • Fentanyl
  • and more…

 

Schedule III Drugs

These still have a potential for abuse but are considered less than Schedule I or II and may lead to moderate to physical dependence, but still high psychological dependence.

Some of these include:

  • Testosterone products, such as AndroGel
  • Buprenorphine, used to treat opioid addiction
  • Codeine
  • Butalbital, used to treat headaches in prescriptive migraine formulations
  • Fiorinal and Fiorcet – a combination of acetaminophen or aspirin, caffeine and butalbital to treat headaches

 

Schedule IV Drugs

These have a smaller potential for abuse and may lead to limited physical dependence or psychological dependence.

Some of these include:

  • Phentermine, used in weight loss
  • Ambien, used for insomnia
  • Benzodiazepines, used for relaxation such as Xanax, Valium, Ativan
  • Belviq, used in weight loss
  • Carisoprodol, used as a muscle relaxant such as Soma
  • Darvocet, used for pain but pulled off the market in the US
  • Tramadol, used for pain such as Ultram

 

What are the pros to AB474?

Many tout this new bill will cause medical providers to pause prior to prescribing large amounts, hence leading to less prescriptions for highly addictive medications.  Thorough histories and exams will be mandatory prior to prescribing and dialogues will need to take place between medical provider and patient regarding abuse potential and the treatment plan.

What are the cons to AB474?

Many fear that the numerous steps providers need to take will be so time consuming and cumbersome that the average physician will avoid prescribing pain medications, sleeping aids, ADHD, testosterone, and migraine medications.  Moreover the fear of losing one’s prescribing licence in Nevada may cause many providers to leave the state.

Nevada sees close to 400 opioid related deaths each year.

 

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

Rev. Jesse Jackson Reveals He is Battling Parkinson’s Disease

Civil right’s activist, Jesse Jackson, revealed Friday that he’s been diagnosed with Parkinson’s disease.

The 76-year-old two-time Democratic presidential candidate stated he and his family noticed changes three years ago and, “after a battery of tests, my physicians identified the issue as Parkinson’s disease, a disease that bested my father.”

His father, Noah L. Robinson, died in 1997 at the age of 88 of a heart attack and complications of Parkinson’s.

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.

substantia nigra

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:

What-Are-the-Stages-of-Parkinson_s-Disease

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

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

 

 

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

Las Vegas Shooting, How YOU Can Help

Sunday night’s shooting of concert goers at the Route 91 Harvest Music Festival has left 58 dead and wounded hundreds others in the deadliest mass shooting to affect the United States.  Here’s how you can help:

Las Vegas Victim’s Fund

Established by Steve Sisolak, Clark County Commission Chair, this fund is helping to raise funds for victims and their families.  Go Fund Me Page is here.

Blood Donation

Thousands of units of blood are needed and can come from local and out of state donors.

United Blood Services have locations throughout the country that can accept your blood Donation. Contact UBS here.

The American Red Cross is accepting donations. On their website, they ask to visit redcross.org.

Moreover Red Cross is taking donations. Call 1-800-RED CROSS or text the word REDCROSS to 90999 to make a $10 donation.

Petition

We are asking President Trump to help declare a National Blood Donation Week.  Please sign and SHARE the petition below:

Petition

Secret Garden Radio For Las Vegas Fund

R&B icon Al B. Sure, Host of Secret Garden @SlowJams Morning show via iHeart Radio & Host of Secret Garden Radio @ our historic KCEP Power 88.1 FM is raising money for victims and their familes here.

National Compassion Fund

Funds will help the immediate and long term needs of victims and their families.  Donate here.

 

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

Was the Repeal and Replace Obamacare Fail a Strategy?

As the Affordable Care Act, aka Obamacare, struggled to stay afloat, Trump and the GOP called for its repeal and replacement.

Premiums, deductibles, Medicaid spending skyrocketed and insurance companies were leaving the exchanges in droves.

A repeal and replacement of Obamacare seemed inevitable, almost necessary, to revamp the healthcare system.

However, once in office, President Trump discovered that a repeal and replacement of a 2300 page bill with thousands of more pages in regulations was much more difficult than it seemed.

When Congressional leaders attempted multiple times to pass various bills to repeal and replace Obamacare, the Democrats held firm in their opposition and the GOP couldn’t seem to unite.  Some felt an all-out repeal was necessary while others thought a repeal could collapse the healthcare system.

And it could.  The ACA was designed like a timebomb, where any molestation of the wires could trigger its detonation.  How do you repeal Medicaid spending?  How do you maintain the highly popular preexisting condition protection while trying to reduce premiums?

President Trump, in response to the lack of progress, called for letting “Obamacare fail”.  If Obamacare was sinking anyway, he thought, Democratic leaders would come to the table to work with the GOP eventually.

There was one problem. The GOP as well as the President were elected to do what they promised, repeal and replace Obamacare.  They couldn’t stand around twiddling their thumbs waiting for Obamacare to fail. Doing “nothing” wasn’t an option.  And if the GOP lost seats in the midterm election, a Democratic majority could infuse more dollars into Obamacare’s life support.

So, try your hardest, or appear to try your hardest, to repeal and replace, and if you can’t, well you did all you could and let the cards fall where they may….the GOP strategy?  It might work.  They can then tell voters during the midterm elections that they tried their hardest.  Meanwhile bipartisan struggles with premiums, deductibles, provider access, lack of insurance choices, and individual/employer mandates might bring everyone to their senses to work together to come up with a replacement.

A divided GOP….maybe not.  Maybe a fail on repeal and replace was the most stratetic move they could make.

 

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

Hepatitis A Outbreak Now Delcared in LA County

The Hepatitis A Outbreak which has killed at least 16 people in San Diego and sickened hundreds more has now surfaced in LA County.

Doug McIntyre of Los Angeles’ KABC McIntyre in the Morning reported 10 people confirmed thus far infected in LA county, primarily affecting the homeless population.  This number is expected to rise.

The Hepatitis A virus is spread by contaminated feces, and many homeless persons lack access to public restrooms and showers.

San Diego County Public Health Officer Wilma Wooten suggested the recent plastic bag ban might have contributed to the outbreak as homeless individuals would use the plastic bag to excrete their waste into and then toss.  Wooten states, “We know people don’t have bathrooms and they can put bags in cans and buckets and maintain good hygiene. That’s why we put plastic bags in the hygiene kits we’re handing out. That’s what we expect people will use them for.”

Hygiene kits have been dispensed containing plastic bags, sanitizer, bottled water, wet wipes and feminine sanitary products.

Without the plastics bags, they are forced to poop without an easy means of clean up, leaving contaminated feces on the sidewalks, streets and encampments.

dog-poop-bags.jpg

City officials in both San Diego and Los Angeles have been spraying the streets with bleach-spiked water.

What is Hepatitis A?

Hepatitis A is a disease that affects the liver.  Its caused by a virus (Hepatitis A virus) that is most commonly ingested. Poor hand washing and/or contaminated food are likely culprits.  Its transmitted by the fecal-oral route, where food or drink contaminated by fecal matter enters another person’s GI tract.  Sexual transmission of Hepatitis A has been reported during activities involving oral-anal sex.

Hepatitis A can live outside the body for months, so unclean dining areas can be contaminated and transfer to food.

Those who are immunosuppressed run the risk of dying from the infection.

 

What are the symptoms of Hepatitis A?

Symptoms of Hepatitis A include:

Jaundice – yellowing of the skin and eyes

Fever

Abdominal Pain

Fatigue

Dark Urine

Joint Pain

Clay – looking stools

Diarrhea

Nausea

Vomiting

Loss of appetite

Hepatitis-A.jpg

 

What is the treatment for Hepatitis A?

There is no specific treatment for hepatitis A.  Most hepatitis A infections resolve on their own.

We usually recommend rest, fluids, and offer medications to help with nausea and vomiting.

For liver injury we avoid medications and alcohol that can worsen liver damage. The liver will usually recover within months after hepatitis A infection.

There are vaccines for Hepatitis A included in the childhood vaccination schedule.  Those older who weren’t vaccinated as a child can get the vaccine from their local provider or health department.  Many states require all health care and food workers to be vaccinated.

The best form of prevention however is good hand washing, dining area hygiene, and cooking food thoroughly.

 

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

Posted in Health, Politics, Sports

Using the NFL Injury Report to Pick this Week’s Winners

The NFL Injury Report tells us all we need to know to make our picks.

For years I’ve been dissecting the NFL Injury Report and predicting who would win during the playoffs and Superbowl. When you’re a doctor who loves football, it’s not that difficult.

So my success has prompted me to make the risky move of posting my strategy and results.  There are varying levels of theory, just like layers of the epidermis.  And each deeper layer of prediction should confirm the simpler ones.  But if I can’t scientifically deduce the winner, I wing it.

Method 1 – Number game

Let’s take for example Thursday night’s game between the Chiefs and the Patriots.  According the NFL injury report, there were 3 injuries reported for the Chiefs and 5 for the Patriots.  A novice may just say 3 is less than 5 so the Chiefs will win.  But as a physician, this is not good enough.   We need to also look at the types of injuries.

Method 2 – Anatomy counts

According to the NFL Injury report, the Chiefs sustained injuries to the knee, another knee and ankle.  The Patriot’s sustained injuries to the  knee, shoulder, ankle, another knee but also hamstring.  Yes, Matthew Slater’s hamstring injury is very telling. Why?

Think about when you were playing football.  If you hurt a finger you still played.  If you sprained your knee, you toughed it out. But what happened when you sustained a groin injury.  You were leveled.  Probably couldn’t even get up.  So any injury involving the groin is physically devastating for a player, and from a psychological standpoint, the whole team.

If a groin injury specifically is not incurred and reported by the NFL injury report, then you look at the injuries closest to the groin.  A head injury is also very concerning so that will come after groin.  Hence the scale from most devastating to least in terms of injured body parts listed is:

Groin < head/concussion < hip< < glute < quad < hamstring  < eye < abdomen < chest < knee < shoulder < calf < arm < ankle < foot < wrist < hand < finger < toe.  

The Patriot’s hamstring injury is closer to the groin than any other injury hence the team wasn’t looking very good for Thursday night’s game.

If specific injuries are not listed, we can sometimes count how many did not participate in practice.

 

Method 3 – Colors 

In case of a tie….meaning both teams sustained equal numbers of groin injuries or subsequent proximal body parts, we look to the main colors of the Jersey.  Black, Blue, Green and Yellow will fare worse than White and Red, Brown. In medicine, Black may happen with necrosis, Blue is associated with hypoxia, Green- mucous, Yellow – gonorrhea.  White and Red are fairly routine and healthy colors in medicine (bones and blood).  Silver and Purple are colors that are fairly neutral as we usually don’t see those colors on a routine basis in medicine unless with hair.

Therefore, the color scale from most problematic to least is:

Black < Blue < Yellow < Green < Orange < Purple < Silver < White < Red.

Again this is only used if predictions cannot be made due to an anatomical tie.  Again I must stress we do not use the color method unless we are unable to predict using the NFL injury report.

With Thursday night’s game, the Chiefs wore white and the Patriots wore blue.   But despite this method, the Patriots were at a disadvantage with the hamstring injury all along.

So what will happen this Sunday?  Let’s use what we learned to predict the winners!!

Jets vs. Bills  

1 Eye injury vs. 1 Concussion

Prediction:  Jets

********************************

Falcons vs. Bears

A Falcon chest injury vs Bears’ two ankles, a knee and finger injury

Prediction:  Falcons

********************************

Jaguars vs. Texans

1 ankle, 1 hamstring injury vs. 1 ankle and 1 shoulder

Prediction:  Texans

********************************

Raiders vs. Titans

foot, quad, knee and back vs Titan’s groin injury – very close but…

Prediction:  Raiders

********************************

Eagles vs. Redskins

0 injuries vs. hip and knee

Prediction:  Eagles

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Colts vs. Rams

Groin, foot, shoulder, hamstring, lumbar plague the colts – zero injuries reported for the Rams

Prediction:  Rams

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Seahawks vs Packers

Calf, shoulder, thigh, wrist, knee ankle vs. ankle

Prediction: Packers

********************************

Panthers vs. 49ers

knee, groin, ankle shoulder vs. hamstring and back injury

Prediction:  49ers

********************************

Giants vs. Cowboys

Concussion and ankle vs. ankle

Prediction: Cowboys

********************************

Ravens vs. Bengals

The Raven’s concussion is up against the Bengal’s ankle and elbow.  Tough call…..

Prediction:  Bengals

********************************

Steelers vs. Browns

A knee and shoulder injury vs. a knee injury

Prediction:  Browns

********************************

Cardinals vs. Lions

Ankle, tricep and calf injury vs. knee and foot

Prediction:  Lions

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We pray that no one gets hurt and those who do recover quickly.  Here’s to a safe season of one of the best sports ever!!  FOOTBALL!!

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