Tuesday, February 12, 2019

Dietary Supplements

So this is what I've been telling my patients who are on no prescription medications but a box full of "natural supplements"... there is really no one ensuring the quality of what is in those medicines... despite it being from a "reputable company"... and they usually cost quite a bit.  So I hope the FDA really does step up and start to oversee... 

Just saying... be careful... and my advice is always to have a conversation with your physician about whether or not anything you are taking is causing any harm...

This is from my AMA Morning Rounds newsletter: (American Medical Association)


FDA to increase oversight of dietary supplements

The Washington Post (2/11, McGinley) reports the Food and Drug Administration announced that it plans to increase oversight of the dietary supplements industry due to increased risks to customers, including “unlisted drug ingredients, and false and misleading claims about health benefits.” The FDA “underscored the need for greater oversight by announcing it had sent 12 warning letters and five advisory letters earlier this month to companies the FDA said are selling dozens of products that contain unapproved drugs or make illegal claims for treating Alzheimer’s and other serious diseases.”
The New York Times (2/11, B6, Kaplan) reports FDA Commissioner Scott Gottlieb, M.D., “suggested that Congress strengthen the FDA’s authority over” the supplements “industry, which sells as many as 80,000 kinds of powders and pills with little federal scrutiny.”

Friday, February 1, 2019


Hope your year is going smoother than mine so far! I've told this story numerous times now to different folks but I figured I'd also record it here... 

So I have spent the first month of 2019 basically recovering from a blow both physically and mentally. All because I was too cocky and did not listen to the sage advice of my nine year old. Picture this...

We were having one of those unusually warmer days during Winter Break, so we were outside. My second child was rollerblading. I thought I'd join her but soon got bored blading around the driveway. I figured I'd go around the neighborhood and get some real exercise.

"Don't go that way, mom!  It's really steep!" Having taken a spill on her bike heading that way before, my daughter warned me with concern in her eyes when she saw me going down towards our neighbors.

"Oh, don't worry. I know how to rollerblade!" I called out to her with a wave of my hand. So off I went and as I rolled past her, I gave her the thumbs up smiling from ear to ear. The next thing I knew, I was flying at lightning speed and before I could think I found myself slammed to the ground skidding down the sidewalk on my right hip and thigh.

Um. Ouch.

But I started to laugh because I realized how ridiculous I must have looked and how right my little girl was. I could not stop laughing but I also could not get up.

"Get daddy!" I shouted at my daughter. My husband who was doing who knows what around the garage finally sees me sitting on the ground halfway between our house and our neighbor's house.

"Take off your skates and walk back," he instructed me.

"Uh... I would if I could!" I hollered back.  Why would I be calling for him if I could do that? So he heads over.

"Why didn't you listen to Ashley?"

"I know... she was right... she was right..." I moaned and we both could not stop laughing. It must have been a sight because I really could not walk at the moment. My husband grabbed one of our kid's scooters and he was attempting to push me back up the hill while I balanced on it. Well it didn't work and I ended up half hobbling and half hopping on one foot to make it back into the house... I was in excruciating pain.

"Hey doesn't this remind you of that time you couldn't walk after jumping that wave?"  Where is the sympathy? Okay... maybe I deserve this one...

So you think I'd put some ice on my leg and lay low for a while. Nope. I think I was in denial. I was like "Hey Ashley, forget rollerblading but let's play some field hockey."

"I'm not sure that's such a good idea, " says my husband. Of course I did not listen to him.

"Oh, it'll only be for a few minutes. I'm fine."

Well... I was not fine because later that night I realized that I had developed a HUGE hematoma... and even now a whole month out, I'm still recovering!

What is a hematoma?

It is a collection of clotted blood within the tissues as a result of broken vessels.

What causes a hematoma?

If it appears on your leg, it is usually as a result of a fall or or a blow to the leg with a blunt object.

What are the symptoms of a hematoma?
  • pain
  • swelling
  • discoloration from the blood pooling under your skin

How do you treat a hematoma?
  • cold compress or ice pack for 20-30min following the injury to reduce swelling
  • rest
  • elevating the leg
  • light compression with a wrapped bandage
  • tylenol for pain
  • heat for 10min three times a day to help increase blood flow
When do you expect to recover from a hematoma?
Most hematomas improve on their own. However, if it is a large collection it can take months for the blood to fully absorb. Occasionally, further intervention such as draining or surgery is required. So if your hematoma does not heal in a couple of days, you should see your doctor to get further evaluated.

Doctors make the worse patients. I didn't do anything I was supposed to after my injury. Now in retrospect, I think I went through the five stages of grief. I was in total denial when it first happened. Then I was angry because I didn't heal immediately and I could not exercise as I had wanted when the new year started. That then sank me into depression when I realized that I am no longer in my twenties when I could fall and still get up and keep playing as if nothing had happened. There was a Saturday this month where I despondently sobbed the entire day with this truth sinking in. Finally, I think maybe I am now accepting the reality of my age and limitations. Oops... I skipped bargaining...  Oh well... my leg hematoma was the physical blow but this acknowledgement was the mental blow. 

All good... this has now given me renewed motivation to be more intentional in eating right, sleeping, and exercising. Here's to a trauma free 2019!