All entries on this blog are written by Anthony Russo, M.D.
as articles in his published column in the Pflugerville Pflag newspaper.
"I got sinus."
Of course you do, we all have sinus cavities. "Sinus" is what we all call it when we get sinus congestion. It sounds more sophisticated when you say allergic rhinitis, pharyngo-sinusitis, and the best of all: rhinitis acuta catarrhalis (RAC) -the common cold.
What about when you have a cough? Say it the Latin way, "tussis". You might want to take some anti-tussive such as a codeine prescription or as Chris Rock tells us about robitussin: " When I was a kid, I had to be near-death to see a doctor, so my daddy got into the habit of putting Robitussin on everything...mo' tussin?"
There is much more that you can do than just suppress the cough. Get to the source of the cough and treat the sinus drainage and the inflammation of the lung airways. For tips on treating drainage see my January 2011 Pflag article which is posted at my blog: pvillehealth.blogspot.com . Also check out the December 8, 2010 article about other doctors in Pflugerville seeing lots of bronchitis in our community: pflugervillepflag.com
Treating inflammation of the lung airways is especially needed if there is any history of having allergies, using lung inhalers or needing breathing treatments, even as an infant. There are steroid inhaler prescriptions that are used as daily controllers to use daily for weeks or months at a time. Treating when the problem first comes up with cough, tightness or wheezing, might prevent the need for IV or oral steroids which have more potential side effects.
Also by prescription are albuterol inhalers to open the airways for four hours as a rescue inhaler. The common mistake is to rely on this type of inhaler and not use a controller. Studies show that if you are needing a rescue inhaler twice a week during the day, or more than once a month at night, then you need better controllers.
There are inhalers which open the airways for twelve hours. Often this type of med is combined with a steroid; one combo is Advair.Did you know that 80% of bronchitis is not from a bacteria, thus do not respond to antibiotics. Often bronchitis is from a virus or allergies. People with allergies often have a mild form of asthma called reactive airway disease.(R.A.D.) So whether you have RAC or RAD, you might need an RX from your prescriber: sometimes it takes more than "tussin!"
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Know your specialist
Would you go to a plastic surgeon for a hand problem? Would you get plastic surgery from an ear, nose and throat doctor? Why can optometrist doctors not do eye surgery and why can psychology doctors not prescribe medicines?
Aside from dentists, podiatrists and nurse practitioners who all can prescribe medicines, one must go through medical school and become a M.D. (medical doctor) or a D.O. (doctor of osteopathy) to write prescriptions. Both of these doctors can be generalists or specialize.
The two main routes are surgery or internal medicine. So a cardiovascular surgeon started training as a surgery intern whereas a cardiologist started as an internal medicine intern. Some other main routes are pediatrics and obstetric/gynecology.
Plastic surgeons do cosmetic surgery but also hand surgery. ENT (Oto-rhino-laryngologist) doctors are also called Head and Neck specialists who can also do plastic surgery of the face. An optometrist (eye doctor) and a psychologist (PhD doctor) are highly trained doctors that do not go through medical school.
Quiz: Find the two correct answers and one false answer.
This specialist deals with:
1) Oncologist/Hematologist: blood cell problems, hemorrhage, cancer
2) Radiologist: x-rays, mammograms and needle biopsies, health advice on the radio
3) Nephologist: dialysis does surgery on the kidney, kidney disease
4) Neurologist: nervousness, headaches, seizure
5) Pulmonologist: asthma, pulled muscles, lung disease
6) Allergist: sinus surgery, immune problems, seasonal allergies
7) Pathologist: lab abnormalities, disease, path of life advice
8) Dermatologist: minor surgery of the skin, skin cancer, ONLY acne
9) Physiatrist (Physical Medicine & Rehabilitation): non-surgical treatment of the bone, joint and spine, refers for physical therapy but does not perform PT, drug rehab
10) Orthopedist: orthodontia (braces for teeth), bone and joint specialist, joint surgery
FALSE ANSWERS ARE:
1)hemorrhage 2)advice 3)surgery 4)nervous 5)pulled 6)surgery 7) advice 8)only acne is not correct since they do other things 9)drug 10)braces
What would you do?
You turn 40 and you understand that you’re getting old age type of arthritis. Do you go to a geriatrics doctor (old age doctor)?
If you had STD or HIV would you go to an ID specialist?
If you had ED would you go to an ED doctor?
If you were having a MI and need a surgical stent to open the blood vessel, would you prefer a cardiovascular surgeon or a cardiologist?
If you have gallstones, a condition related to liver disease, would you see a liver specialist or a general surgeon?
If you were having a baby, which doctors might be necessary and why: pediatrician, obstetrician, neonatologist, family physician? And if you needed a C-section surgery, which two of the above might be able to perform it, depending on their particular training?
ANSWERS:
Geriatricians only see the elderly. Infectious Disease docs do treat sexually transmitted disease and HIV & AIDS. Emergency Dept (Emergency Room) docs do not usually treat erectile dysfunction; however if side effects of ED meds last over 4 hours then go there! If one survives the initial stages of a Myocardial Infarction, then a cardiologist can put in stents through a blood vessel without needing a surgeon. Gallstones are typically treated by a surgeon. All of these specialists could be involved during childbirth, depending on the situation. Many family physicians are trained in delivery and even performing C-sections.
Which of the following are not recognized specialties?
sports medicine, wilderness medicine, occupational medicine, sleep medicine, energy medicine, palliative medicine, cave medicine, aviation medicine, toxicology medicine.
ANSWERS:
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Medical doctors by specialty
Psychiatric specialties
Allergy / Immunology
Anesthesia
Angiology
Aviation medicine
Cardiology
Dermatology
Disaster medicine
Emergency medicine / dept (ED)
Endocrinology
Family medicine
Gastroenterology / Hepatology
Genetics
Geriatrics (Gerontology)
Gynecology /Obstetrics
Hematology / Oncology
Infectious diseases ( ID)
Intensive care medicine
Nephrology
Neurology
Ophthalmology
Oral and maxillofacial surgery
Orthopedics
Otolaryngology (ENT, Head & Neck)
Palliative medicine
Pathology
Pediatrics
Psychiatry
Pulmonology
Radiology
Rehabilitation medicine
Rheumatology
Sleep medicine
Sports medicine
Surgery
Toxicology
Transplantation medicine
Urology
Wilderness medicine
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Do you Know Me? / Know your Shots
Most people just think about vaccines when they need a "booster" or want to be immunized for travel. Let’s think about it from the perspective of each vaccine: they have their own name, their unique disease prevention use. Answer the quiz below.
DO YOU KNOW ME…
1) I am one of the vaccines that protects you from diseases that are named after countries; match them:
Measles Japanese
Encephalitis Spanish
Influenza German
2) I used to be just for college kids and military recruits. The disease I protect against, flourishes in crowded places like dorms, and it messes with your brain.
3) "Don’t drink the water" is what they say when you travel to certain places. True, it’s a good idea for preventing "traveler’s diarrhea"; some people get this from being exposed to bacteria they are not accustomed to. CDC.gov gives out great travel and vaccine advice. But which two of the following travel vaccines prevent other water-borne diseases? (I) typhoid fever, (II) yellow fever, (III) hepatitis A only, (IV) hepatitis A, B&C
4) I am one of three vaccines with a similar name: sometimes I'm referred to as "small", or with a "fowl" name or with a simian name.
5) I can prevent what used to be a routine childhood illness, chickenpox (varicella). My name is Varicella vaccine. But did you know that years or decades later, this pox can come back as a painful rash on one side of the body. Did you know that chickenpox is related to herpes? Did you know that older adults should be getting me as a vaccine? Do you even know my name? Is it (I) HerpesChickenPox, (II) Herpes Zoster(shingles) or is it (III) HerpesNobodyKnowsMe
6) If you knew me, you would know what the sound of a whooping crane has to do with the modern tetanus shot ,Tdap. Hint, it has something to do with the 'p' in Tdap. What does the 'p' stand for and what is the nickname of this disease? And by the way, what do pigs have to do with the naming of H1N1 influenza.?
7)True or False: You’re never too old for vaccines.
8) True or False: Get a tetanus shot so the wound won’t get infected.
9) True or False: Even if everyone in the world were vaccinated for one disease, you still would not rid the earth of that disease.
Answers:
1)Japanese Encephalitis ,Spanish Influenza, German Measles
2) Meningitis vaccine is now given, even before the teenage years. This disease infects the covering of the brain, the meningis.
3) I and III are correct : water-borne diseases include typhoid fever and hepatitis A only. The other forms of viral hepatitis are hepatitis B and hepatitis C; they are spread more like AIDS and other blood borne and sexual contact diseases. There is no vaccine for hep C but there is new treatment available. Most children in the last few decades have gotten the typical 3 dose shots of hep B vaccine. In some people the vaccine doesn't take the first round, and in some they lose protection over time, needing a hep B booster.
4)pox – small pox, chicken pox, monkey pox
5) Zostrix is a vaccine for shingles (also called herpes zoster). To be clear, herpes is very different from chickenpox and shingles.
6) ) the "p" in Tdap stands for pertussis, also called whooping cough; it was named after the whooping sound of the cough when you get the pertussis disease. H1N1 influenza is also called swine flu.
7)True. You’re never too old for vaccines
8) False. The truth is that a tetanus shot does nothing for the wound, it justs prevents a severe illness called tetanus (lockjaw)
9) False. The truth is that smallpox is essentially non existent because of extensive worldwide vaccinations for it.
Do you know which of the following diseases don’t have vaccines for adults?
Trick question - All of these do have vaccines that can be used in adults
Anthrax, Cervical Cancer, Diphtheria,Hepatitis A, Hepatitis B, Haemophilus influenzae type b (Hib), Human Papillomavirus (HPV), H1N1 Flu (Swine Flu), Influenza (Seasonal Flu), Japanese Encephalitis (JE), Lyme Disease, Measles, Meningococcal, Monkeypox, Mumps, Pertussis (Whooping Cough), Pneumococcal, Poliomyelitis (Polio), Rabies, Rotavirus, Rubella (German Measles), Shingles (Herpes Zoster), Smallpox, Tetanus (Lockjaw), Tuberculosis,Typhoid Fever, Varicella (Chickenpox), Yellow Fever
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Women's Healthcare Struggle in Texas History
National Women's History Month encourages us to honor those historical women in our own regions and in our own institutions. I am from Galveston and much of the early history of medicine in Texas happened in Galveston. I trained at John Sealy Hospital which was built in 1891. Until 1920 women doctors only graduated from UTMB at the rate of one every other year. Many early Texas female physicians had to be trained outside Texas and in private schools; often schools had be to set up for women only. In 1897, Marie DeLalondre Dietzel became the first female MD graduate from UTMB.
According to The Texas State Historical Assoc (tshaonline.org), women med students met opposition: “I prefer prescriptions written by a masculine hand; shan't submit my pulse to anything that wears a bonnet." Even as of 1926, female medical graduates struggled to be allowed to serve internships. One reason given was that there would be resistance on men's wards. “The hospital board of John Sealy Hospital, after vigorous debate, decided that Misses Edith Bonnett and Frances Van Zandt would be allowed to serve internships.” This was with restrictions however. These women MD's had to go unpaid during two 6-week terms of rotation on men's wards, while MALE students filled in for them!.
It is interesting that there were more female medical doctors in 1900 than in 1950 in the U.S. Italy seemed to be more progressive in incorporating women in ancient medicine. Wikipedia's entry on “Women_in_medicine” states that the 11th century saw the emergence of the first universities but women were excluded, except in Bologna when it opened in 1088.. Dottore (Dr) Trotula was chair at the Salerno medical school. Dr. Bucca was another distinguished Italian physician. She held a chair of medicine at the Bologna U. for over forty years in 1390.
“Women Physicians in Early Texas Medicine” (mcgovern.library.tmc.edu) is a beautiful display of photos and bios such as for Dr. Emma Beck, born 1888, Fredericksburg; Dr. Caroline Crowell, 1893, Austin; Dr. May Turner Stout, 1888 , Galveston; Dr. Cora White Trevitt, 1867, San Antonio.
Dr. Violet Keiller was born in 1887 in Scotland but was raised in Galveston. The name Keiller caught my eye because the Keiller building was where we had our anatomy lab. It was named after her father, but medical schools have honored her for her distinguished career.. Another bio on her is in the book: “Women Pioneers in Texas Medicine” by Elizabeth Silverthorne, Geneva Fulgham . (I will have the link on my blog, listed below, where all of my Pflag articles appear.) Her mentor described her as his seventy five pound medical student. She was elected to the student council, but she and the other 14 women med students attempted unsuccessfully to pass a mandate to always have at least one woman council member. Years after retiring, her portrait was in a hall of a Houston medical school and caught the eye of a faculty member. He learned how loved she was by the students. He was intrigued by her face, with the “bright-eyed gaze and determined chin.” The lab at Hermann Hospital is named after her, the first physician to be memorialized. Her microscope is on display there.
For many interesting facts about the history of women in Texas medicine, go totshaonline.org and search “women and health “ by Ceryl Ellis Vaiani:
-1809 Texas Governor Salcedo ordered all midwives to be licensed after an exam. This attempt to decrease infant mortality often isolated women from sources of support, advice, and care when faced with illness.
-The major treatment in outbreaks of smallpox and cholera was Indian or Mexican folk medicine with prayer.
-Jane Long, the first white to give birth in Texas, was cared for in her birthing and illness by her slave Kian, in Bolivar. This occurred in the winter of 1820 while her husband was at war.
-During the turbulent decade forming the Republic of Texas, men were gone from their homestead and women ran the farms. Susanna Dickinson and Andrea Castañón served as nurses at the Alamo.
-Women assumed responsibility for family and slave health; they decided when to call for professional help.
-Many black women, both slaves and free, also provided nursing care and midwifery services, and concocted drugs.
-Magazines and newspapers had remedies for cures. The Southern Lady's Companion ran articles on health and healing of special interest to women.
-The Texas Health Journal in 1888 was devoted to the exposure of fraud remedies and quacks. The strict regulation of patent medicines was accompanied by increased reliance on doctors and therefore a loss of females' ability to manage their own and their families' health.
- Along with the right to vote, women strongly advocated equal access to medical education. This was intertwined with the health movement for better sanitation, pure food and drugs, better public health and medical facilities. Also many were anti-tobacco and anti-alcohol.
-Galveston had a training program for midwives in 1890 and listed it as an official occupation
-Catholic congregations of women supplied the first trained nurses in Texas
-The first nursing school in Texas was at John Sealy Hospital in 1890. Six more schools developed by early 1900.
Nursing education became the bridge by which women
extended their traditional domestic role of caring for the sick, into the public world, of work.
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