Palpitations

Feeling irregular or fast heart beats?

The complaint of irregular or fast heart beats (often grouped as palpitations) can be frustrating unless there is an electrical recording of your heart beat while feeling the symptom.

It is not uncommon for a patient to present to the Emergency Room to report of having felt a fluttering of the heart, or a pounding of the beat, or a rapid pulse; yet often these symptoms have fully resolved by the time of arrival to the hospital. Therefore, the electrical recording of the heart (EKG) would most likely be normal. Because further evaluation and treatment depends heavily on the type of heart beat (arrhythmia) that caused the symptoms, it is very important that the Doctor have an EKG recording at the time of symptoms. It is not unusual for a patient to present to the doctor multiple times before able to record the EKG while experiencing the symptom.

There are multiple reasons a person may experience palpitations and these include: anxiety, benign paroxysmal supra-ventricular tachycardia, atrial fibrillation, as well as potentially fatal ventricular tachycardia.  Because of the wide spectrum in severity of the disorders, you should get medical evaluation at the time of the palpitations. Further evaluation beyond an EKG will probably be required.

Follow the links for more complete discussion:

WED-MD: what are heart palpitations

Mayo Clinic: when to have palpitations evaluated

Depression & Genetics

Can depression be considered genetic?

The genes given to us at birth by our parents form the blueprint from which we develop as human beings. The person we actually become is a result of the interaction between this blueprint and the environment we grow up in. The capacity to take that blueprint and improve on it is a unique characteristic of each of us.

What we do inherit is the vulnerability to developing depression; but our capacity to overcome this vulnerability is a result of our social interactions. The family we grow up being part of, the friends we call upon for support, the creative outlets we invent, and our physical ability to endure the challenges, each of these factors influence to what degree we experience depression.

The loves and interests we develop in our lives, as well as professional guidance, offer us the support to help us successfully face depression.

Follow the links for more complete discussions:

Depression and genetics

Summary on depression & genetics

Healthline: Is depression environmental or genetic?


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Cholesterol

What are the treatment options for elevated cholesterol?

Cholesterol is essential for rebuilding and maintaining your health; but as your body produces all the cholesterol needed, whatever cholesterol you eat beyond a natural balance is simply available for storage, such as deposits on the walls of arteries. These deposits (plaques) can block the blood flow to your heart, or brain and other vital organs, and thereby increase your chances of getting a heart attack or stroke.

Treating high cholesterol is complicated and best worked out with your doctor. Lifestyle changes, such as better nutrition and exercising, can often help some individuals significantly lower their cholesterol, but also decrease the risk of diabetes and high blood pressure.

When lifestyle changes are not enough, medications can help lower your cholesterol, and thereby markedly decrease your risk of a heart attack or stroke.

Follow the links for more complete discussions:

Web-MD treatment of high cholesterol

US Health: overview on elevated cholesterol

Lifestyle changes to lower cholesterol


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Gall Bladder

What is the treatment for gall bladder stones?

The gallbladder looks like a draw-string purse positioned below the liver. Like a purse, it stores chemicals (enzymes) produced by the liver and released into the intestines to help you break up the fatty foods you eat. Occasionally, gallstones (cholelithiasis) are formed, and these may at times cause very severe pains. The pain usually develops after a fatty meal (like pizza, or fried chicken), and is primarily located in the right upper abdomen. It is often associated with a back discomfort and vomiting; if fever is noted, an infection of the gallbladder may have developed.

Gallstones do not always cause pains (become symptomatic); it is possible to live an entire life with gallstones and never have problems. Treatment is, therefore, not necessary if you are not having symptoms. But as the pains can be severe and unpredictable as to when they may arise, as well as life threatening complications can develop (infection, blockage of the liver, inflammation of the pancreas), treatment is most often recommended when symptoms develop.

Treatment is primarily considered if symptoms develop; the most definitive is to remove the gallbladder through surgery. Laparoscopy is the most common method, and this involves making four small wounds in the abdomen. It involves a short recovery period. Outside of surgery, other treatments such as drugs, special ultrasound therapy, and diet are not as effective. Best approach is to review with your Doctor all available options.

Follow the links for more complete discussions

Care of Gall Bladder

Nonsurgical treatment

Diet to prevent symptoms


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Fever in Children

At what fever shall a child seek medical attention?

An ill child is a parent’s anguish, and a cause to seek medical attention.  Fever is often the only feature that defines the presence of an illness. Yet fever is part of a large assortment of “natural defenses” the child’s body assembles to fight off any infectious process, such as the common cold or pneumonia. I describe fever to be a “natural antibiotic” which helps protect your child.

It is not so much how high the fever gets, but more importantly the other signs of illness the child may have developed. Consider a congested cough for pneumonia, headache and stiff neck of meningitis, cherry red tongue of Kawasaki Disease, the lethargy of bacteria in the blood. As a parent, you are your child’s renowned expert and primary protector; if there are symptoms that concern you, obtain medical attention.

Follow the links for more complete discussions:

emedicine on fever

fever is good

natural care of fever


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About Me

I graduated from the University of California in Los Angeles (UCLA) with a Master’s in Public Health (specializing in Maternal Child Health) and went on to get a medical degree from University of California at Irvine (UCI).

Looking back it seems like a million years since I began my medical practice; but actually it was 32 years I worked in Emergency Medicine. I am now happily retired.

One thing I often tried to get across to the patients I attended to was an understanding about the medical condition that brought them in for emergency care. What surprised me was the many times a patient would listen intently to the discussion I presented and then offer that no doctor previously had taken the time to elaborate.

From patients’ reaction to instructions for the care of their medical condition, I learned it was not so much failure of physician to provide the information but rather to give an opportunity for the patient to ask whatever question was left in their mind. WhyDoc is an opportunity to give you that opportunity.

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