Carrie Fisher died December 27th, four days after suffering cardiac arrest on board a flight from London to LAX and this week the autopsy report reveals cocaine, heroin, methadone and ecstasy could have contributed.

At the time of death, the 60 year old, was having multiple apneic episodes, in which she stopped breathing in her sleep. A variety of factors can contribute to this but the coroner in his report stated, “Based on the available toxicological information, we cannot establish the significance of the multiple substances that were detected in Ms. Fisher’s blood and tissue, with regard to the cause of death.

The report also stated she took Lamictal and Abilify used for Bipolar disorder and mood stabilization, as well as Prozac, used for depression and anxiety.  She appeared to also take oxycodone, not prescribed to her.

It has not been confirmed that narcotics led to her respiratory depression that could have induced sleep apnea and later cardiac arrest.

Unfortunately it's common for those who suffer from Bipolar Disorder to also suffer from drug addiction. Bipolar disorder, or commonly known as manic depression, is where one has unusual shifts in mood, energy, activity and can go from highs to lows in their mood within a short period of time.

Drugs may induce this type of psychiatric illness and conversely bipolar disorder may induce drug use.

The beloved actress battled drug addiction and in a 2013 statement to the Herald-Tribune said, “Then, by the time I was 21 it was LSD. I didn’t love cocaine, but I wanted to feel any way other than the way I did, so I’d do anything.”

In 1985 she was diagnosed with Bipolar Disorder and had been an advocate for earlier diagnosis of mental health issues.

Her cardiac status was unknown until recently when she had her “episode” on the London to LA flight.  Carrie Fisher became a global sensation in the 1970’s in Star Wars‘ Princess Leia.

Here autopsy report can be found here:  351717158-Carrie-Fisher-Autopsy-Report

 

LearnHealthSpanish.com / Medical Spanish made easy.

 

Daliah Wachs, MD, FAAFP is a Board Certified Family Physician. The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

Published in News & Information

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” and “shot in the calf”, but had been stable upon initial treatment in the hospital.  Currently we are told by MedStar Washington Hospital Center at approx. noon PT, that the House Majority Whip  “was critically injured and remains in critical condition.”

 

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.  It's 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.  It's 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:

 

LearnHealthSpanish.com / Medical Spanish made easy.

 

 

Daliah Wachs, MD, FAAFP is a Board Certified Family Physician. The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

Published in News & Information

June 14th is World Blood Donor Day.  Established by the World Health Organization in 2004, World Blood Donor Day thanks donors and raises awareness for the global need of blood products. Blood banks throughout the country, including American Red Cross and United Blood Services, are holding drives to help keep their stores full for local hospitals and medical centers.

 

Blood products are used for trauma patients,  those whose blood counts are low due to anemia, and many who suffer from blood disorders. One pint of blood could be used to save three lives.  Whole blood donations can last “on the shelf” for 42 days, but platelets, which provide clotting factors, only last for 5 days.

 

Donors are therefore needed year round.  One can donate blood every 60 days and platelets can be donated every week for up to 24 weeks a year. Although 38% of the US population is eligible to donate blood, less than 10% actually do.

 

World Blood Donor Day helps bring much needed blood during the summer months when less people donate. In 2016 a United States National Blood Donation Day was created along with a National Blood Donation Week, with multiple states creating state blood donation days during the first full week of September.

 

nvbloodme

Doc. Daliah putting her blood money where her mouth is.  

 

Campaigns such as these remind people that blood is needed year round.

The World Blood Donor Day slogan this year is “What can you do?”….

Give Blood, Give Now, Give Often…..

 

To find the nearest blood bank near you, visit:

http://www.unitedbloodservices.org/

http://www.redcross.org/give-blood

 

LearnHealthSpanish.com / Medical Spanish made easy.

Daliah Wachs, MD, FAAFP is a Board Certified Family Physician. The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

 

 

Published in News & Information

A Houston boy who went swimming at Texas City Dike over Memorial Day Weekend died days later from reportedly “dry drowning,” or possible “secondary drowning.”

 

“Dry Drowning” sometimes gets confused with secondary drowning. The latter occurs when fluid gets into the lungs when one swims and hours, or days later (out of the water), causes respiratory failure.  As will be discussed below, dry drowning causes a spasm of the vocal cords which inhibits breathing.

 

Frankie, 4 years old, appeared fine until a few days later, his father, Francisco Delgado, Jr., said he appeared to be suffering from a minor, stomach ailment. Then one morning the boy woke up with shoulder pain, and “Out of nowhere, he just woke up. He said ahhh.”  His father told KTRK, “He took his last breath and I didn’t know what to do no more.”

 

Despite efforts by paramedics and the parents, Frankie passed. A GoFundMePage has been created for the family to help with funeral expenses.

What is “Dry Drowning” and “Secondary Drowning”?

Dry Drowning occurs when water touches the first pass of the respiratory tree, one’s vocal cords, larynx.  When water touches this area a reflex is triggered, causing a spasm (laryngospasm) such that the vocal cords constrict and close up the airway. It's a defense mechanism designed to prevent water from falling into the lungs. However, laryngospasm causes immediate hypoxia, lack of oxygen, and if not reversed, the victim will die.  In dry drowning, water never officially reaches the lungs.

 

bronchi_lungs.jpg

 

In Secondary Drowning, water gets inhaled and sits in the respiratory tree and if uncleared through coughing, will sit and prevent proper oxygenation. Moreover the water will irritate the lung linings causing more fluid and inflammation, resulting in pulmonary edema. This could occur hours to days after the water activity.

 

According to Florida Hospital Tampa pediatrician, Dr. James Orlowski, these events are very rare, comprising only 1-2% of drowning incidents.

What are the symptoms?

The symptoms for both “Dry” and “Secondary Drowning” are similar in which the victim could have any of the following:

 

  • Cough

  • Chest Pain

  • Difficulty Breathing

  • Shoulder Pain

  • Neck Pain

  • Confusion

  • Irritability

  • Behavior Changes

  • Fatigue

  • Difficulty speaking

 

to name a few…

Prevention

Horse play in water should be avoided. This includes bathtubs, plastic pools, hot tubs, pools, lakes, ocean, etc.

 

Never swim alone.

 

Swim in areas staffed with lifeguards and/or appropriate supervision. If water does get inhaled watch the child or adult to look for any of the above symptoms. If concerned seek medical help immediately.

 

LearnHealthSpanish.com / Medical Spanish made easy.

Daliah Wachs, MD, FAAFP is a Board Certified Family Physician. The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

Published in News & Information

How clean is the air in your home?  Noxious chemicals build up very quickly in one’s house.  These include:

 

Carbon monoxide (from heaters, fireplaces).

 

Radon (from soil, drains, pipes).

 

Formaldehyde (from tobacco smoke, new wood furniture, flooring and cabinets, and glue, cosmetics and detergents).

 

Volatile Organic Compounds/benzene/trichloroethylene, (from plastics, rubber, detergents, degreasers).

 

Ammonia (from detergents, cleaners).

 

Xylene (from cigarettes, paint and car exhaust).

 

These chemicals have been linked to a variety of illnesses from “sick building syndrome” which includes fatigue, myalgias, asthma, headache, palpitations and possible nosebleeds to cancer and possibly death.

Household plants can help eliminate these from the air that you and your family breathe.

 

The following 12 household plants may come in handy:

 

Aloe Vera -- helps reduce benzene and formaldehyde.

 

Spider Plant -- reduces carbon monoxide and formaldehyde.

 

Boston Fern -- removes formaldehyde.

 

Snake Plant -- removes benzene and formaldehyde.

 

Areca Palm -- removes most of the above mentioned chemicals and has been rated, “Most efficient air purifying plant” by NASA and the Associated Landscape Contractors of America. (Pictured above).

 

Lady Palm -- removes formaldehyde and ammonia.

 

Bamboo Palm -- removes benzene, trichloroethylene and formaldehyde.

 

Peace Lily -- removes benzene, ammonia and formaldehyde.

 

Golden Pothos -- removes most of the above chemicals.

 

Dragon Tree -- removes xylene.

 

English Ivy -- removes formaldehyde and mold.

 

Chinese Evergreen -- multi-talented as well eliminating much of the above chemicals.

 

LearnHealthSpanish.com / Medical Spanish made easy.

Daliah Wachs, MD, FAAFP is a Board Certified Family Physician. The Dr. Daliah Show , is nationally syndicated M-F from 11:00am-2:00pm and Saturday from Noon-1:00pm (Central) at GCN.

 

 

Published in News & Information

On Thursday, by a slim margin, the vote of 217-213 was one over the 216 votes needed to pass the bill.

 

The AHCA includes an amendment that includes $8 billion in spending over 5 years to subsidize high risk pools that could be affected by the “waivers” offered to states who wished to opt out of requirements that insurance companies cover preexisting conditions.

 

Freedom Caucus members who opposed the first draft of the bill, supported this new bill, crucial to allowing President Trump to make good on his promise to “repeal and replace” Obamacare.  Representatives Fred Upton and Billy Long switched their vote from “no” to “yes” bolstering GOP support for the bill that could not lose more than 22 votes.

 

The American Health Care Act has had to appeal, not to Democrats, but to GOP members who were split on whether the AHCA repealed too many popular components of Obamacare.

 

The original AHCA including 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. Maintaining 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.

The bill is being analyzed by the Congressional Budget Office (CBO) and will need to be approved by the Senate to move forward.

 

LearnHealthSpanish.com / Medical Spanish made easy.

Daliah Wachs, MD, FAAFP is a Board Certified Family Physician. The Dr. Daliah Show , is nationally syndicated M-F from 11:00am-2:00pm and Saturday from Noon-1:00pm (Central) at GCN.

 

Published in News & Information
Friday, 21 April 2017 18:28

HIV Found to Live in SECOND Cell Type

Over the past 3 decades, researchers have made phenomenal gains in the fight against HIV.  The deadly virus attacks the T-lymphocyte cell, specifically CD4, then causes the immune fighting cell to churn out more HIV virus’. CD4 T cells send signals to the body’s immune system when something foreign is in its path, recruiting more immune cells to the scene. When HIV has used the CD4 T lymphocyte cell to replicate itself, the latter dies. As CD4 cells drop, so do immune defenses. HIV could lead to AIDS, Acquired ImmunoDeficiency Syndrome, giving rise to infections that healthy immune systems could normally withstand, but an immuno-compromised patient could not.

 

Anti-HIV drugs have targeted how the virus attacks the T-cells, and specifically how its DNA enters the T cells to cause its parasitic replication; however, millions of HIV individuals have yet to be “cured”, even if their viral load remains low or undetectable. Many cases have been reported of an individual with undetectable HIV coming OUT of remission, with reactivation of the virus.  If T-lymphocytes have short life spans, how does HIV persist? The assumption exists that HIV hides out in a reservoir. But where?

 

Researchers from the University of North Carolina discovered that the HIV virus can live in macrophages. Macrophages are derived from monocytes, a type of white blood cell that finds, engulfs, and destroys pathogens as well as debris and dead cells in the body.  I picture them to be Pac-Men that can gobble up unwanted microscopic particles, including bacteria, and will “digest” the substances they engulf with enzymes. Moreover macrophages alert the immune system of their work and that something foreign is in the body, just as CD4 T cells do.  However, one major difference is that the macrophage can live for months, even years. This could make a cozy home for an HIV virus that hasn’t been destroyed by the macrophage’s enzymes.

 

According to Dr.  Jenna Honeycutt, lead author and postdoctoral research associate in the UNC Division of Infectious Diseases, “The fact that HIV-infected macrophages can persist means that any possible therapeutic intervention to eradicate HIV might have to target two very different types of cells.”  Their findings were published this week in Nature Medicine.

 

In January, Professor Ravindra Gupta, from the University of College London, and colleagues also found HIV to infect macrophages.   HIV replication appears to be active in the brain, where the virus targets macrophages.


With these new developments, researchers want to now investigate where infected macrophages hide and hopefully find new therapeutic interventions that would limit HIV’s entry into this ubiquitous immune cell.

LearnHealthSpanish.com / Medical Spanish made easy

 Daliah Wachs, MD, FAAFP is a Board Certified Family Physician. The Dr. Daliah Show , is nationally syndicated M-F from 11:00am-2:00pm and Saturday from Noon-1:00pm (Central) at GCN.

Published in News & Information