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Archive for the ‘Covid-19’ Category

Bluebells at Katoski Greenbelt 2020

April 28, 2020 @ 10:40 am
posted by Dr Ginther

The parking lot on the south side of Ridgeway just east of Blackhawk Creek is fairly empty due to Covid guidelines.  Social distancing is easy on the more than mile long trails through the woodlands.

Spring Beauties are everywhere this early.  Virginia Bluebells are nearing their peak of tens of thousands of blooms.  Trout lilies are at peak although less common.  Blue, white and yellow violets and buttercups are blooming as well.  False Soloman seal are just starting to bud.

Katoski Greenbelt is a springtime Blue Zone.

Jay Ginther, MD

Bone Health Gets No Respect

April 24, 2020 @ 5:32 pm
posted by Dr Ginther

As testing increases, we are finding many individuals have been infected with Covid-19.  Many have no symptoms.  Many do not know that they have it.  The overall death rate when counting everyone infected is looking like less than 1%.

The same is true regarding Clinical Osteoporosis.  Many do not know that they have it.  There are no symptoms except a fracture.  Up to 80% of those with thoracic vertebral fractures do not know they have had one.  Up to 20% of those with a recognized vertebral fracture die within 6 months from complications of their osteoporosis.

A hip fracture is hard to miss.  Hip fracture can be the first symptom of severe clinical osteoporosis.  Like Covid-19, hip fracture (Clinical Osteoporosis) is most dangerous in those who are older and/or have pre-existing chronic diseases (co-morbidities).

Over 20% of older men who fracture a hip die of complications within 6 months and many die within weeks.  This is comparable to older men with Covid-19 who require a ventilator.  Yet osteoporosis gets no respect.  More than half the time osteoporosis is not even listed as a contributing factor.  And rarely is the hip fracture listed as the cause of death.

We consider Covid-19 to be the cause of death even if we only suspect it.  Perhaps it is time to consider a treatable chronic disease like osteoporosis in the same way.

Jay Ginther, MD

Fear of Covid-19 Can Kill

April 19, 2020 @ 6:20 pm
posted by Dr Ginther

We have discussed who is at the highest risk of death from Covid-19 or other diseases or injuries.  The usual suspects.  Those with serious chronic diseases:  Elderly, especially male; Diabetes, especially poorly controlled; Heart disease and blood pressure problems; Lung diseases like COPD, Asthma, Emphysema, especially those dependent on oxygen or inhalers.

None of these can be cured, but all can be controlled or made less severe.  That requires careful management.  Labs, other tests, discussion with the managing healthcare provider often need to be done every month or 2 or 3.  Medications need to be adjusted.  Careful management of chronic disease is not “elective”.  It is “essential”.

Fear of Covid-19 is keeping many with unstable chronic diseases from their usual testing and management.  Others delay going to hospital for worsening symptoms.  Waiting until your problems are severe makes even ICU care less likely to succeed.

Telemedicine can be an answer, but talk only is not as good as being able to see the patient.  Many older persons do not have a computer or smart phone which would make them visible to their healthcare provider.  Drawing blood tests by phone does not work either.

Most hospitals and many doctor’s offices are mostly empty making social distancing feasible.  Call your healthcare provider to arrange for needed management of your disease.  Adjustments can be made such as Drive-Thru Care.

Do not let fear of Covid-19 put you at greater risk of complications of your pre-existing chronic disease.

Jay Ginther, MD

Cause of Death – Covid-19?

April 17, 2020 @ 5:44 pm
posted by Dr Ginther

The death toll from Covid-19 is rising daily.  New York and Washington state seem to have reached a plateau in daily deaths.  Eventually every state will peak and then decline in deaths related to Covid-19.  But what exactly is a Covid-19 death?

When I was trained, the cause of death for a person was the immediate cause of death.  Deaths now attributed to Covid-19 would have been due to respiratory failure or pneumonia or some other complication of viral infection.  Covid-19 would have been a contributing cause or even the precipitating cause, but not the final cause.

Today, anyone who dies having tested positive plus those not tested but possibly having had Covid-19 has that listed as the cause of death.

As we discussed last time, most of those who die with Covid-19 already have serious chronic diseases.  Pre-existed chronic diseases should be counted too.

Poorly controlled diabetics are at higher risk of death from all causes, but diabetes is rarely listed as THE cause of death.  COPD, asthma, emphysema and chronic steroid inhalers are the same.  Heart attack is listed when the underlying cause was high blood pressure or high cholesterol or diabetes.

Listing every underlying cause makes the total causes of death total way over 100%.  But it can give us a better handle on the chronic conditions which debilitate individuals to the point that almost anything can finish them off.  Pre-emptively testing for and treating chronic diseases will lower the death rate from Covid-19 and whatever comes next.

Jay Ginther, MD