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Minutes of Y's Men Meeting of February 16, 2017

Robert Altbaum, Richard Ellis, Jay Kleeman, Martin Krauthamer, Kenneth Wright

Q What are the causes of opioid addiction, Dr. Wright?

A.  This is an extremely widespread problem that is usually the cause of deaths of those in their 20s, 30s and 40s.  It has many causes, but one is the emphasis that was put on pain. Doctors saw this and did everything they could to alleviate pain and this frequently meant opioids, which, unfortunately, led to many addictions.  Now, 35,000 deaths a year result from opioid overdose.

Q.  Dr. Altbaum, how can a patient get the most out of a doctor visit?

A.  Arrive on time and be organized.  Have a list of your medications and supplements and report any lifestyle changes.  A doctor only has a limited time with each patient so you also have to prioritize what you want to cover.

Q.  Dr. Ellis, how does radiation kill cancer cells?

A.  Radiation is a controlled injury to the body that affects cells with electrically charged ions.  There are different types of radiation and differing means of delivering it.  Radiation itself can cause cancer if improperly administered.

Q.  What are the danger signs for a heart attack, Dr. Krauthamer?

A.  It is typically pain that can occur in the chest or in the arms, or elsewhere.  It is a heavy pain.  Everyone should learn to take their own pulse as a dramatic change in pulse indicates problems needing attention.

Q.  Dr. Kleeman, how do you know when you need orthopedic surgery?

A.  To revisit opioids for a moment as it is such a major problem.  We find that once opioids come into play it is very hard to get off them. But now there are new pain protocols that eliminate the need for opioids in a lot of cases.  One key element of these is to get people moving as quickly as possible.

Q.  Dr. Wright, when should you consult a plastic surgeon if you have a laceration?

A.  What you need for a laceration is a plastic surgery closure.  Modern ER doctors can all do this. You don’t need a plastic surgeon.  Plus, getting a plastic surgeon means waiting for one to get to the hospital and frequently, not covering his fee with insurance.

Q.  Dr. Ellis, what is the difference between an MRI and a CAT scan?

A.  CAT scans use radiation while an MRI uses a strong magnetic field.  Both show cross sectional images of the targeted area of the body.  But CAT scans are more effective to view bones while MRIs are better to view soft tissue.

Q.  Martin, What is the difference between pacemakers and defibrillators?

A.  A pacemaker guarantees a minimum rate heart beat through electrical impulses.  A  defibrillator shocks the heart if it is in ventricular fibrillation, which is a more serious situation requiring attention within 4 minutes or there is brain damage.

Q.  Jay, how bad is running for joints?

A.  This is very controversial.  It varies from person to person.  Bottom line, exercise is very important.  If you like it and can do it then do it.  But at all costs avoid smoking, which is terrible for your bones.

Q  Dr. Wright, how bad is Zika?

A.  Zika is a mostly tropical disease, which is asymptomatic in most people, but can be devastating to women who are pregnant as it can cause, among other things, microcephaly.

Q.  Bob, what about sex after 60?

A.  It is very common to have problems as we get older.  There are many things that can affect it.  If you are young and have it, it may indicate some coronary problem. Now there are drugs that are very effective as well as other approaches if the drugs don’t work.

Q.  Is there a stroke team at Norwalk hospital?

A.  Yes there is and their work begins in the field when a report comes in that someone has stroke symptoms and is on the way in.  They are a very efficient team.

Q.  What improves with age?

A.  Wisdom.

Q.  What is happening with medical careers?

A.  There are fewer and fewer general practitioners.  We are depending more and more on physician extenders such as nurse practitioners.  Also, there has been insufficient compensation for the field of geriatrics so there are few in this area.  This is being addressed.

Q.  What about statins?

A.  They are wonderful, but can cause some aches and pains in a few people.  They have terrific effects on overall health.