From The Desk Of Dr. T

By rteitelbaum March 12, 2020
We DO have a cure for the corona virus-it's our very own immune system-the miracle we all are carrying around in our bodies. Eighty percent of the known cases are mild. There is a sense that there are a significant number of cases that are minimally asymptomatic. The scenario goes like this: On Monday you know you are not right and may be coming down with something. On Tuesday, you have body aches, maybe a cough, slight fever, some tightness in your chest. You know you have something, maybe a cold. On Wednesday, it's the same, but on Thursday and Friday you feel much better and by the weekend you're back to your old self. 1. You did not go to the doctor. 2. You probably went to work. 3. You did not become a statistic in the total number of cases. 4. You can spread the virus with one cough or sneeze without being very unwell. 5. You didn't think much of the whole experience, though you may test positive--if you were tested. 6. You have immunity to that virus for the rest of your life. There are people who may have been exposed who have no symptoms at all. They also do not show up in any statistics. That number can be in the hundreds of thousands compared to the @120,000 worldwide cases right now. The thought that liberated me, that got me past this ridiculous and dangerous media-driven panic, is that this Covid-19 is already all over the earth. You can't stop incredibly small viral particles from being spread by air currents. You can't quarantine a virus--although we are valiantly trying and failing. Yes, they are heavier than air--if you have a laboratory space where there is no air movement they will fall to the earth. But those are not the realities of living in an active atmosphere. A very timely university study (sorry, I can not remember the source) analyzed the particles you see floating near the window in the early morning sunshine. They found that 80% of them were of human tissue. Why be surprised? Every four weeks we shed a complete layer of skin. It goes into the air and into your mattress and pillows where millions of ant lions live and feast on your flakes. Consumerlab.com today posted a detailed list of supplements that can be helpful with this pandemic. Zinc, Vitamin C, Vitamin D and N-acetyl cysteine are helpful in reducing symptoms and mucus secretions, It is the latter that actually kills people who cannot clear their alveoli of these secretions. Mucinex and guaifenesin, both available in every pharmacy may also be helpful. A cousin of mine is a father to a cystic fibrosis daughter and he told me that "in the CF community, NAC (n-acetyl cysteine) and guaifenesin are used a lot". Aerosols are preferred over pills and NAC used to come in a spray but has not been available for over a year. Why? Who knows. I tell my patients "everything you do good for yourself counts." I am going to let that and the biology I carry around with me every day get me through this period. Remember in the beginning when experts said the corona virus is in a family of viruses that cause the common cold? Well, welcome to your new cold. This may be deadlier than your usual flu season, but who out there thinks it's going to be like the Spanish flu epidemic of the early 20th century? Robert Teitelbaum,DPM
By Dr. T August 28, 2019
To make a very long story short--- I have been giving out Celecoxib 200mg from a supply in my drug fridge for a couple of years now. I might give out 4 of them, taken once daily, for four days following a heel pain syndrome injection. I asked four pharmacists a couple of years ago " What would be your choice for an NSAID?", and they all said Celebrex. They thought that for short term, the fact that it works in a different cyclo-oxygenase cycle, makes it less irritating to the lining of the g.i. tract. A major paper in The New England Journal of medicine about four years ago looked at the cardiac history five and ten years down the road of taking the drug and concluded (as the Editor did, in an editorial they have in every issue) that it is "maybe safer than Motrin." Maybe the wrong drug is the over the counter favorite. Recently, I prescribed 24 Celecoxib 200mg for a patient with occasional gouty attacks, where it can be very effective, as are many of the NSAIDS. The cost was $175.00. Now, understand this is a generic drug that's costing $7.29 per pill. Of course, I got the Prior Authorization 2 page fax from the chain pharmacy. Having just read Jon Hultman's article in P.M.Magazine about the 700 million hours doctors waste on this task per year--I was is no mood to go through this charade. So I called up my patient, and said "Larry, come to the office and I'll give you twenty pills for $10." I've been getting them from Moore Medical for $23 per 100. Once it was $30 for a bottle. Big deal. That's still 23, or 30 cents apiece. So what is the story with this $175.00 cost? The story is that this is the fraud that Big Pharma commits every day on us countless of times. There was a time when Celebrex went off patent some 8+ years ago. Then, the name brand sold for $10 a pill and the generic was $7. It took years until an Indian firm produced them when it was selling for the $23 price. India, I understand is the country on earth that has the largest generic drug industry. No surprise they came up with it. I made a telephone call to the lady pharmacist and told her what I paid for them at the office. The chain pays less than that, obviously. " I asked "Why don't the part D insurance companies recognize the fact that it doesn't cost that much anymore?" One thing for sure, the chain is happy with that. But it is a humongous rip-off. And she had no answers for any of my questions, which I understood. American Medicine has become what I call "The Big Trough", and we are going to have to end that to survive ourselves.
By Dr. T August 28, 2019
When a practitioner who has some intelligence has been doing his thing for some decades now, his observations are worth listening to. I have dealt with hundreds, if not thousands of diabetic patients through the years. Type I, II, even gestational diabetes, usually found at the end of multiple pregnancies. People who have diabetes in their families for generations, and now, more likely, diabetes with no family history.
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