Erythritol, a common artificial sweetener, may be associated with an increased risk of cardiovascular disease (i.e., heart attack and stroke). Since erythritol is not heavily metabolized and is excreted in the urine, the FDA classifies it as “generally recognized as safe.” Just drinking a beverage with erythritol increased blood levels of erythritol for several days. Combine that...Read More
Given the severity of the Fentanyl poisoning epidemic in every part of our country, I wanted to summarize the pharmacology information for you. Fentanyl is a member of the opiate class of medications. These are derived from the opium poppy. Morphine would be one such medication and is the starting point of where everything else comes from. What I...Read More
As you have heard in the news, there is a fentanyl epidemic where synthetic Fentanyl made in China and brought into the US by drug cartels is poisoning people. It has become so bad that many cities have vending machines for the Narcan antidote. Fentanyl is a member of the opiate class of medications. Opiates are derived from...Read More
In the midst of the Fentanyl epidemic, there is now a new drug of abuse called Xylazine, or “Tranq.” This is a veterinary medication used to sedate animals, but it has been leaking out onto the streets and creating issues as it has no “antidote” such as Narcan (the reversal agent used for opiate overdoses, such...Read More
The CDC is exploring a link between Pfizer’s new bivalent COVID vaccine and stroke risk. The CDC has a real-time data monitoring system for adverse events, and this has shown a POTENTIAL link between the vaccine and strokes in people over the age of 65. Specifically, out of 500,000 Medicare beneficiaries, 130 patients suffered a stroke...Read More
The FDA granted accelerated approval of a new Alzheimer’s disease medication called Leqembi, made by the pharmaceutical company Eisai Global based on its ability to “may” slow down the progression of cognitive decline early on in the disease. It works by decreasing the number of amyloid plaques in the brain which appear to be the key...Read More
It was announced this week that singer Celine Dion has a condition called Stiff Person Syndrome (SPS), also known as Progressive encephalomyelitis with rigidity. This is a rare neurological autoimmune condition where the body’s immune system attacks the nerves from the brain that control the muscles. Unfortunately, this results in stiff muscles and severe spasms in the torso...Read More
Hospitals, Urgent Care Centers, and Pediatric offices are overwhelmed by an early surge of Respiratory Syncytial Virus (RSV). This virus typically presents with cold-like symptoms but is quite contagious to children and adults, not just because of the sneezing and coughing, but because it tends to hand around on surfaces such as tables, handrails, phones, and...Read More
In order to allow patients to refrain from significant travel to have a surgical procedure done in a hospital, we are seeing an explosion in the number of ambulatory surgery centers or ASCs. Many people prefer to have surgery close to home and preferably in their own community. Hospitals are now intertwined with real estate companies...Read More
As you know, each year a new influenza vaccine is created based on the most likely predominant strain. The good news is this year’s vaccine seems to be quite effective. Unfortunately, currently the US is seeing an enormous surge in influenza with 23,000 people already hospitalized. This is 12 times higher than what we saw in 2019. Hospitals...Read More
One of the best ways to get your emotions and concentration under control is via meditation. Now typically, a guy like me would never be able to meditate as my mind is always thinking about my patients or new ways of healing. It used to be that meditation was done by making you sit and...Read More
Dear Patients: In addition to social distancing, hand washing and sanitizing, and wearing masks, another way to stay safe and add to your armor is with these 4 supplements. The supplements seem to boost the immune system and create an inhospitable environment for bacteria and viruses. My medical philosophy is to be proactive and prevent illness instead...Read More
I wanted to shed some light on why there is a discrepancy between how different patients respond to the same medication. Simply put, when a medication is taken orally, it gets absorbed from the gastrointestinal tract and passes through the liver where a group of enzymes called the Cytochrome P450 system metabolize the medication. Some patients have...Read More
Many of you have asked me about Long Covid, which clinically is now called Post COVID-19 condition (PCC). It refers to those individuals with continued symptoms, with fatigue being the most common, lasting more than 12 weeks after developing Covid-19. Researchers have determined that there is dysfunction in the mitochondria which are the “power houses” or energy producing organelles...Read More
Botulism is a neurological condition characterized by paralysis due to the effects of a toxin called botulinum toxin. The bacterium Clostridium botulinum synthesizes and releases the toxin which binds to receptors on muscles and subsequently paralyzes them. There are several types and I will cover the two main ones: Food-borne is often found in issues...Read More
There is yet another subvariant of the omicron strain called BA.4.6. It should be noted that the Greek letters previously used for COVID such as alpha and delta will no longer be used as everything will now be a subvariant of the omicron. Now the subvariants are mutating into more subvariants. It’s getting hard to keep up....Read More
A new vaccine from Novavax has been approved for COVID boosters. Unlike the Pfizer and Moderna vaccines which use mRNA (genetic material), this is a more traditional vaccine that just uses a protein like other traditional vaccines such as tetanus. For those with concerns about mRNA vaccines this provides an alternative. Even though it is...Read More
I am writing this blog due to the recent chaos caused by Hurricane Ian. Unfortunately, there will always be natural disasters such as hurricanes, tornados, floods, earthquakes, blizzards, and noreasters. There are some aspects I wish to address: If there is an advanced warning such as with Hurricane Ian, it is extremely important to follow guidance...Read More
I wanted to provide an update/education on something interesting. As some of you know, I was trained as a “physician-scientist” meaning that in addition to my M.D. degree, I obtained a graduate degree in Pharmacology (the study of medications) at the same time. As such, on some of my blogs, you will see me delve into certain...Read More
I wanted to provide a basic reference for some of the cosmetic toxins that exist in US products. Many have been banned in Europe who happens to be ahead of us in eliminating toxins from their cosmetic products. I will blog in the future about some of the issues with chemical sunscreens. For now, here...Read More
In the previous entry, I described that some humans have the ability to “smell” certain diseases. This is also the case with animals such as dogs and cats. There was a well-known case in a nursing home that involved a cat that was used in Pet Therapy to lift people’s spirits. Somehow, the cat knew who...Read More
Parkinson’s disease is a neurological condition characterized by difficulty moving, fixed facial expressions, tremulousness, slow speech, and even dementia in the form of “Lewy Body Disease.” A 72-year-old woman from Scotland who has a genetic condition associated with an extremely sensitive sense of smell can actually smell people who have Parkinson’s disease. Scientists in England tested...Read More
The new COVID vaccine is out which contains the original Wuhan strain (which is what the original Pfizer, Moderna, and J&J vaccines including the two boosters contained) as well as the two variants of the Omicron strain called BA.4 and BA.5. It is called a “bivalent vaccine” because of containing those two different strains. In...Read More
The FDA has approved a new neuromodulator named Daxxify which is produced by the company Revance. Neuromodulators are those medications containing Botulinum Toxin (such as Botox, Dysport, Xeomin, and Jeuveau), which are typically used as a cosmetic procedure to reduce fine lines and wrinkles. What makes Daxxify different from the other neuromodulators is its longevity average...Read More
I wanted to provide a monkeypox update. First, I wanted to reassure people that this seems to spread through sexual activity and prolonged contact with the droplets from vesicles or very close and prolonged exposure to respiratory droplets and saliva. Also, droplets in bedding, clothing and towels used by someone with monkeypox can also occur. The most common...Read More
Many people who have elevated cholesterol levels are on a class of medication called “statins,” which include Lipitor (the generic is called atorvastatin), and Crestor (the generic is called rosuvastatin). There are two ways in which our body obtains cholesterol. The first is externally from the diet, and the second is by the synthesis in the liver. Statins...Read More
The Monkeypox B1 variant is a virus from the non-variola (smallpox) orthopox viral class. So, it is not smallpox and cannot give you smallpox. It causes painful blisters or rashes around the anal, rectal, perirectal, genital or mouth. Prolonged close exposure with the genital sores or lesions of a symptomatic individual, (such as receptive anal intercourse), is how...Read More
A class action lawsuit has been filed against Mars, the maker of the candy Skittles, for having high levels of food additive titanium dioxide (TiO2). Mars uses this to create the mixed colors of Skittles. Titanium dioxide is also used in sunscreen, roofing materials, plastic, paints and adhesives. The European Food Safety Authority noted that...Read More
I received a lot of positive feedback and interest in my “how to handle a shark attack” blog. Since the last blog, there were two minor shark attacks just last week alone (including a lifeguard who was in the middle of shark attack training!), around the Jones Beach/Fire Island area in Long Island, NY. This...Read More
Given we are now in the full swing of summer, and everyone is enjoying the warm weather and beaches, I wanted to give a brief, easy-to-remember snippet of information regarding something you will hopefully never have to deal with. That is a shark bite. The first piece of advice is to decrease the chances you...Read More
A recent study published in the American Journal of Psychiatry demonstrated that people who use cannabis chronically and long term from age 18 through mid-life have cognitive deficits that are more significant than even those seen in long term alcohol abuse. Of note is that another study demonstrated that those who began regular cannabis use...Read More
I would like to thank you for subscribing to my medical blog. I hope the information I provide will be of assistance to you and your loved ones. My goal is to educate and provide guidance on maintaining your health or improving your condition if you or your family, friends and colleagues are ill or...Read More
I know many of you know that antibiotics are only good for bacterial but not viral infections. We used to think there was nothing you can do for viral infections. However, based on several studies, there are inexpensive supplements that can actually fight the viruses that cause colds and the flu. If taken at the...Read More
As many of you know I am a proponent of using Arnica Montana to prevent and treat bruising, swelling, inflammation and pain. Arnica Montana is a natural, homeopathic remedy which has been shown to reduce bruising and swelling from trauma without side effects or interactions with other medications. Specifically, Helenalin, the main component of the...Read More
Male pattern baldness is thought to come from an excess of the male hormones called androgens. Specifically, DHT, which is an androgen produced by the conversion of testosterone via an enzyme called 5 alpha reductase, binds to the follicle causing it to shrivel away. There are some over the counter remedies for baldness. Minoxidil was...Read More
There is a new medication that has incredible promise for the autoimmune condition called Multiple Sclerosis or MS. Gilenya (fingolimod is the generic name) may not only cause neurons to grow, but also decrease the rate of neuronal cell death. MS results when our own immune lymphocytes attack myelin, the “insulating tissue” surrounding and protecting...Read More
Viral Gastroenteritis may be caused by a variety of viruses but the end result is usually the same. Either you are experiencing the unpleasant symptoms of nausea, vomiting, diarrhea or a combination of the three. As with all illnesses, if your condition is caused by a virus and not bacteria antibiotics are of no use....Read More
10/6/15- I know many of you are aware that Vitamin D3 supplementation results in a decrease in the frequency and duration of colds and flu. Multiple studies have been done demonstrating that vitamin D3 supplementation can lower our risk during the winter months. It is likely our use of SPF and avoidance of sun exposure...Read More
I wanted to mention that while I typically address aging from “the inside” using fillers and botulinum toxin under the skin, I also work with patients on “the outside” with skin care. Although every patient is different, there are certain things that work in almost anyone. The first step should be used by 100% percent...Read More
The Art of the Cosmetic Consult: I was recently asked to write down my thoughts concerning the factors contributing to the aging face. I always note that our facial appearance is determined by both genetic and environmental (sun, smoking and diet) factors. The good news is aging, although inevitable, is modifiable if the cosmetic work...Read More
As medical technology allows patients to grow older, we see this technology being used in an inappropriate way to prolong life in a very painful and unsatisfactory way for the patient. The patient’s family is then left with the uncomfortable decision on whether to continue or withdraw care. The most important thing we can do...Read More
While Botox and Dysport act “superficially” meaning on the muscles near the surface of the skin to reduce and soften fine lines and wrinkles, fillers work deep and fill or “inflate” deep folds and wrinkles from the inside out.Read More
