BACK  PAIN
  It has been said that back pain is second only to upper respiratory infection as a source of reasons to visit the doctor. 80% of people get back pain at some point. In one year alone, direct medical costs were 12 billion dollars and another 30 billion dollars in indirect costs.
  The cause of certain types of back pain are difficult to pinpoint. Diagnosis such as osteoporosis, malignancy, diskitis, and aneurysm are made only in about 5% of the cases. Disk degeneration is often blamed but this problem is a natural part of aging and is present in many pain-free people. Most back pain is mechanical in nature. It involves spasms of muscles and poor alignment of bony structures. Most causes involve poor posture and poor lifting techniques.
  Back pain that is worse at night or accompanied by  bowel or bladder symptoms or back pain that doesn't improve when you lay down are signals to come in and have a complete work up. Patient with back pain and histories of prostate, lung, breast, thyroid or renal cancer should also readily present themselves for complete work-ups.
  Treatment of localized back pain is not difficult to prescribe. The difficulty in the treatment is the acceptance by the patient. The treatment with which 80-90% get better in 3 - 12 weeks is rest and restricted activity. It's very hard to prove that other things work. Sure, there are muscle relaxants, traction, anti-inflammatory medicines and injections but none of these seem to consistently work. Rest and restricted activity remains the best treatment modality. The problem is that patients will not adhere to the treatment plan for more than a week.
  For some patients with back pain of at least 6 months duration the treat-ment modalities are also limited. Things that help are: using good body mechanics (proper lifting technique), weight control, aerobic exercise, physical therapy, and long acting non-steroidal anti-inflammatory drugs. NOT considered a main treatment modality for chronic back pain is long term prescriptions for pain medication. The realization in chronic back pain is that they probably won't be cured. The goal is to make them better in a drug free treatment plan.

COOKIN'

Everyone has hobbies. One of mine is cooking and I have been doing a lot of it lately. Problem is that it has been affecting my "doctorin'". A patient ask me how he could make his liver better and I told him to try a pound of onions.....another patient ask me what his chills and fever brought to mind
all I could think of was Shake and Bake........gee I wish I knew how to insert some drum rolls in between these jokes.

HYPOTHYROID

 The thyroid gland is a gland that is found on each side of the neck in the area of your "Adams apple".This gland produces hormones that help regulate many body functions. If the amount of hormone get too low the condition is called Hypothyroidism. This condition is difficult to diagnose especially in the elderly.
  Symptoms and signs such as cold intolerance,fatigue, slow mentation, raspy voice, dry skin, and hearing difficulties may be barely perceived or mistaken  for manifestations of aging. The elderly patient may or may not have a goiter (a large out-growth in the neck). Sometimes, because of fluid retention caused by hypothyroidism, the presentation will appear much like congestive heart failure. Some people that have high blood pressure, especially when the bottom number is high, will have hypothyroidism. Many people that have anemia may have as the cause hypothyroidism.
  If you have any of these undiagnosed symptoms, mention Hypothyroidism to your doctor.....hey, we need reminders too sometimes.