Thursday, February 26, 2009

Vitamin D and URIs

When all around the wind doth blow,
And coughing drowns the parson's saw,
And birds sit brooding in the snow,
And Marion's nose looks red and raw.
---William Shakespeare

Denver weather includes some wind, no snow, and no brooding birds sighted in our bushes. Lots of patients coughing in the waiting room, however, drowning in their own secretions, their throats, noses, and eyes red and raw. Colorado scientists, revisiting data from the Third National Health and Nutrition Examination Survey, conclude, as have others before them, that a lack of vitamin D is at the heart of these viral matters(1).

They conducted a 'probability survey' based on six years of results looking for an association between a person's vitamin D levels and a recent personal history of an upper respiratory tract infection. Indeed, those persons with puny little D levels (<10 ng/ml) were nearly twice as likely to have had a recent viral URI as those with robust amounts of D on board (30 ng/ml or more).

To give you a notion of what's common here in sunny Colorado, I don't see one person in ten whose D levels break the 30 nanogram level. In many patients who claim to take at least 400 units of D per day in their multi-vitamin pills, levels hover in the low teens.

No one has time for a viral URI. If you don't want the problem, check and see if you have D problem; get your D level checked.
( 1) Arch Intern Med. 2009;169:384-390.

Sunday, February 15, 2009

Winter vomiting disease

Lovely, huh? WVD is the UK name for the 1-2 day intestinal crud whose hallmark is...vomiting! And I can personally attest that it's a toilet-hugging disaster--been there hugged that all yesterday afternoon.

As noted in The Rocky Mountain News recently, WVD--caused by the norovirus (and rather picturesquely as the 'small round structured virus' or SRSV)--is currently epidemic here in Colorado. Here's what Brit SRSV expert Professor Steve Field had to say:

Generally you do not need to go and see your doctor.

Because, dear patients of mine, if you go and see your doctor with it, as about 10 of you did last week, she will get it too. That said, I finally got my son to call my doctor--the lovely and talented internist Adele Sykes--to rush over ASAP (leaving her Valentine's Day dinner party to do so) with a phenergan shot to put me out of my misery. Now I know why all of you who are her patients love her so--she was a veritable angel of mercy in a red sweater with a red band about her more or less reddish hair, and she certainly saved my sorry self from hours more of misery.

Maybe, then, we should have those of you who peel yourself off the bathroom floor to visit us with WVD sneak in the back door where a gowned and glove assistant will shoot you up too. And if you're too sick to travel, know that this too shall pass provided you don't pass out and break your head open.

Wednesday, February 04, 2009

How would you have handled this one?

My long-time patient has struggled with alcohol abuse in the last two years. She's been in and out of rehab plus had several hospitalizations with serious illnesses indirectly linked to her addiction. Now she's back to work and looking the best I've seen her in ages. She came in alone yesterday regarding a mild skin ailment--her daughter usually accompanies her-- and walked slowly and a little unsteadily into the exam room due to a 'minor ankle sprain'.

After our pleasant visit, I gave her a hug and realized she smelled of alcohol.