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Tuesday, January 14, 2020

Cataract surgery: Types, what to expect, and recovery

Cataract surgery is among the 10 most common surgeries in the USA. Cataracts may be prevented by blocking ultraviolet light to the eyes. So, wear those sunglasses. They are not only fashionable, but they are also good for your eye health. 😎
from Rajesh Harrykissoon, MD

Saturday, January 11, 2020

10 Most Common Surgeries in the U.S. | Estimated Surgery Cost

Angioplasty with or without stent placement is one of the 10 most common procedures in the USA. A recent study has called into question the need for stenting in asymptomatic individuals: "Patients with severe but stable heart disease who are treated with medications and lifestyle advice alone are no more at risk of a heart attack or death than those who undergo invasive surgical procedures, according to a large, federally funded clinical trial led by researchers at the Stanford School of Medicine and New York University’s medical school. The trial did show, however, that among patients with coronary artery disease who also had symptoms of angina — chest pain caused by restricted blood flow to the heart — treatment with invasive procedures, such as stents or bypass surgery, was more effective at relieving symptoms and improving quality of life." -source: The key differentiator is whether the individual is symptomatic or asymptomatic. Discuss with your doctor.
from Rajesh Harrykissoon, MD

Knee replacement surgery: What you need to know

Joint replacement surgeries are among the 10 most common surgeries in the USA. Many conditions may cause joint damage, but the most common reason is related to obesity. In general, the lower extremity joints experience 30 lbs of force for every 10 lbs of weight gain. The correlate is true, losing 10 lbs, will off-load 30 lbs of impact force from the lower extremities joints. Apart from increased load-bearing damage, the knees may splay outwards to maintain balance, called a valgus deformity ("knock-kneed" appearance). As the balance is thrown off, the gait may shit to a "waddling gait" as characterized by the vertex of the skull listing side-to-side while one walks (the vertex of the skull should stay midline and true with a normal gait). This side-to-side rocking gait increases stress on hip joints setting them up for damage. The magnitude of the joint stress directly correlates with the degree of the list from the vertical (0 degrees is normal, 5 degrees from vertical is increased stress, 15 degrees from vertical is more stress yet). Remember, as weight increases the axial skeleton does not. The axial skeleton for an individual at 150 lbs is the same as that individual at 350 lbs. As one's weight increases, the center of gravity shifts higher and higher thus, one becomes top-heavy and prone to tipping over (analogous to rollover risk of a truck vs a car). The lower body tries to compensate by splaying out the joints seeking a wider base for stability.
from Rajesh Harrykissoon, MD

Friday, January 10, 2020

Could gene therapy cure sickle cell anemia?

A truly exciting breakthrough! The cure for sickle cell disease through gene therapy by using the vector of the HIV virus may be the doorway to curing thousands of genetic disorders. Turning the apparent scourge that is the HIV virus into a savior...remarkable! But, potentially controversial as is all genetic modifications. The crux of the controversy is one of wisdom rather than of ability. Whether that genetic modification is to an ear of corn, to a tomato, for a new breed of dog, to livestock or to disease cure for a person, the wisdom of it sparks debate. Usually, in such debates when one states we don't know the wisdom of it, what we are really saying is that we don't know what we don't know--the risks and the unintended or collateral effects--which have yet to manifest, to be appreciated in terms of downstream benefit and harm and, thereby, to be fully assessed in terms of value to mankind. Genetic modification is not new. Humans have been genetically modifying every plant and animal we have domesticated since the dawn of civilization. What has changed is the pace of that modification. We no longer have to depend on generations of the reproductive life cycles of such organisms to breed a more drought-tolerant ear of corn, a more pest-resistant tomato, or a different breed of dog, we can now do it seemly overnight.
from Rajesh Harrykissoon, MD

Wednesday, January 1, 2020

Abolish Texas Medical Debt

Happy New Year 2020! Resolve to perform a random act of kindness. I don't often promote one charitable organization over another, but the crippling effect of medical debt on Americans who have done nothing but commit the crime of getting ill and requested help back towards health is heartbreaking. Ideally in a first world country like the US, bankruptcy, destitution, and depression due to medical debt should not occur. This does not occur in other first world countries. Until our expectations of healthcare coverage as a right and our voting behavior that it's a privilege (and not a right) are aligned, families succumbing to medical debt will continue to be an issue. Caring for each other through illness is a human condition. The moment in our human development on this planet that we stopped to attend to the cripple, ill and to morn the death of a fallen in our tribe, we separated ourselves from many other species on the planet who with little pause simply stepped over the ill/fallen amongst their group and continued on. Denying this human attribute of compassion and attending to the ill is akin to denying we need oxygen to live. Hopefully, we shall reconcile this discrepancy by aligning our healthcare expectations and our healthcare voting. In the meanwhile, I would encourage you to engage in a random act of kindness and to forgive the medical dept of your fellow American though a donation to charitable organizations such as RIP Medical Debt. RIP Medical Debt does not forgive individual medical debts but buys medical debts in bulk from debt collectors and forgives the debt in total including paying the taxes so there is no tax obligation to the recipient of the medical debt relief. Texas is among nine states in the nation where families are burdened the greatest. Abolish Texas Medical Debt in 2020:
from Rajesh Harrykissoon, MD

Saturday, December 14, 2019

Pertussis | Whooping Cough | Outbreaks | CDC

Persisting cough? Is it due to "cedar fever," a viral infection, a bacterial infection or other? This time of year it can be difficult to sort out because of the seasonal convergence of contagion and allergen triggers. When families and friends gather to celebrate the holiday season is the perfect setting for contagion to spread like wildfire. Get immunized before Uncle Fred and nephew Timmy turn up at your front door this holiday. Most acute onset cough or acute bronchitis will improve in about 10 days and does not require antibiotics. What you can do to protect against serious causes of infectious illnesses this time of year is to stay up today with the influenza vaccine, pneumococcal vaccine and pertussis vaccine. Get immunized with: -Tdap shot -Pneumococcal vaccine -Flu shot
from Rajesh Harrykissoon, MD

Wednesday, December 11, 2019

Don’t Let it Happen to You: Practice Fined Over Social Media

I've been in this predicament where I know a social media post to be misleading or blatantly in error, but it's so tricky to respond because protected health information is not just name and date of birth or other such identifiers but it is also information which may lead to the identification of an individual. For instance, if one posts about a gunshot wound to the head coming to the hospital, without stating anything else, that may be a violation of HIPAA because in a community this size gunshot wounds to the head are rare occurrences so that sole information may be sufficient for a third party out there to go, "omg, I know who that is!" I and many physicians are not able to specifically respond to posters for this reason...risk of HIPAA breach.
from Rajesh Harrykissoon, MD