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Effective Healthcare Medical PBC

Hippocratic truth in the delivery of medicine

Author Image Nattydread
COVID-19: An endovascular systemic disease

Even though COVID-19 disease is caused by the SARS-COV 2 virus entering the human body mainly through the respiratory system, it is not a respiratory disease. The virus also proliferates in the sinuses, and thus enters our neurological system, causing a lot of damage. Any system in the body with a rich capillary network for blood supply is heavily prone to clotting, and thus ischemia, and ultimately the death of tissues/cells in that ischemic penumbra/area.

Systems in the body that are detrimentally damaged by this microvascular clotting are mainly; the neurological/psychological system resulting in central nervous system injury with subsequent peripheral nerve damage, the respiratory system with extensive lung scarring, the cardiac system with resultant arrhythmias, the renal system with chronic renal failure, and the gastrointestinal system. These systemic sequela thus can morph into chronic or long haul COVID-19, which can effect 50-75% of COVID-19 disease survivors.

Long haul/chronic COVID-19 disease

Chronic COVID-19 disease is very debilitating, and is normally multi-systemic. The bone crushing fatigue alone leads to such functional impairment, that there will a population of seriously disabled patients applying for disability, and early retirement in the next 6-12 months. Treatment for chronic COVID-19 disease is currently supportive. I recommend optimization of thyroid/parathyroid function, meaning levels above the 50th percentile, which includes hemoglobin level, and Vitamin D/B12 levels. I also recommend high doses of Vitamin C with rose hips/bioflavonoids, dose of 2,000-3,000 mg daily, as well as, Magnesium Citrate 800 mg to 1,200 mg daily. All doses should be adjusted if renal failure is present.

Prevention of microvascular clotting

If the patient is not on Lovenox subcutaneously after discharge from the hospital or was never hospitalized, then keep the blood thin with herbs such as Red Panax Ginseng, and Gingko Biloba should be adequate. Avoid Vitamin K in vitamins/supplements, and foods rich in Vitamin K.

No cure for COVID-19

Currently there is no cure for COVID-19 disease. The cure is actually in the prevention of the disease, or being an unavailable host, by wearing masks in public areas, physical distancing, and excellent hand hygiene with 20 seconds hand washing. Remdesivir shows promise as a therapeutic agent, and convalescent plasma is also helpful. Hydroxychloroquine treatment remains controversial, more robust academic studies need to be performed for the role of Hydroxychloroquine as a therapeutic agent.

Author Image Nattydread
Endometriosis: A systemic disease

Endometriosis is a progressive chronic autoimmune inflammatory disease that affect 1 in 10 women of reproductive age, which can sometimes start at 9-11 years old. It is an extremely debilitating disease, which is often misdiagnosed, and under diagnosed. There are two types invisible/microscopic disease (Stage 0), and macroscopic disease (endometriomas/pulmonary with catamenial pneumothorax). It mainly affects the reproductive system with severe menstrual cramps, however, most women have some aspect of systemic endometriosis, since it also simultaneously affects the psychological system with PMS/PMDD, respiratory system with restrictive lung disease/pneumothorax, the neurological system with migraines, the musculoskeletal system with diffuse myalgia, endocrine system with severe fatigue, and gastrointestinal (GI) system with constipation/diarrhea, and nausea/vomiting.

Rampant misdiagnosis

Since endometriosis is a systemic disease it is often misdiagnosed, for example, as irritable bowel syndrome (IBS), chronic medication induced migraine, and fibromyalgia. I call the disease the great Chameleon. It is important to note that women understand that endometriosis is initially a clinical diagnosis, there may not be any macroscopic findings (Stage 0), and laparoscopy may be initially negative for macroscopic disease, this does not negate the fact that there are endometrial ectopic foci that are invisible.

Diagnosis and Treatment

As previously mentioned endometriosis is very difficult to diagnose especially for Stage 0/invisible systemic disease. There is a blood test that was developed, but it is only 90% sensitive. Thus, there is a 10% chance that the patient is positive for disease but the test says that the patient is negative. Otherwise, it is a clinical diagnosis until there is macroscopic disease seen on laparoscopy, which can take up to 20-25 years to manifest.

Treatment is mainly hormonal with utilization of birth control therapy, such as oral contraceptives, Mirena IUD, Climara Pro patch or combinations of the aforementioned hormonal therapy. GnRH agonist/antagonists such as Leupron or Orilissa are also used. The side effects of these therapies can be devastating, but Orilissa works really well, if the side effects can be tolerated for at least 6 months. Surgical options include a hysterectomy or hysterectomy with ovary removal. The ovaries when removed prior to menopause can be very detrimental to women’s health, even with hormone replacement therapy.

Traditional Chinese Medicine with locoregional treatment such as acupuncture with moxibustion, reflexology, and cupping, is also extremely helpful. Energy medicine techniques such as Krieger-Kunz Therapeutic Touch, and Tai Chi are also invaluable tools in the armamentarium for treatment of endometriosis. Herbs such as Pau D’ Arco, Astralagus, Red Panax Ginseng, Gingko Biloba, Nopal, Graviola and Reishi Mushroom are also critical to controlling systemic endometriosis. Memorial Sloan-Kettering’s complimentary medicine herbal website is an excellent source for informational education about these herbs relative to academic research.

Adjunctively, counseling is very highly recommended secondary to the debilitating effects of excruciating pain, symptoms being disregarded, and being told that symptoms are psychological, can be very damaging to a women’s global health, and daily routine care.