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IN THIS ISSUE
Appendicitis
Sports Injuries
Chemical Experiment
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Issue: #37
September 1, 2014
Inner Coastal Red Drum Fishing

Volume 4, Letter 37
 

September 1, 2014

  

Appendicitis has been a troubling illness for humans for centuries. It is an inflamed and infected appendix that can progress to a serious and life threatening infection and death without appropriate management. 

 

Medically, until recently it was believed that an appendix had no function in the human gut. A biologist and researcher at NC State named Rob Dunn has proposed an alternate theory. The appendix is the store house for our good and friendly gut flora. 

 

If you have a serious diarrheal illness or get exposed to antibiotics, it is now believed that the appendix reseeds the gut flora with your good bacteria. There is now data showing that humans that have their appendix removed have a three fold increase in serious GI infections like Clostridium difficile. Everything in our body is there for a reason even if we do not understand it. 

 

Historically, the treatment for acute appendicitis is surgical removal. The cure rate is high. The downside is high cost and a surgical intervention that can have complications. 

 

In a new prospective study dated April 2014 from the Journal of the American College of Surgery we have evidence for a novel non surgical approach. Dr. Minneci looked at uncomplicated appendicitis cases and offered the parents of the patients two choices: 1) standard appendectomy or 2) intravenous antibiotics for 24 hours followed by 10 days of oral antibiotics. Caveats to offering the choice were that the patients had pain for less than 48 hours, no radiographic evidence of rupture or abscess, and had a white blood cell count less than 18,000. 

 

90 % of the patients had a successful non operative course. 3 patients had to go on to appendectomy without any further complication. 

 

The cost of this therapy should be dramatically better than the surgical route. The patients returned to school 2 days earlier and parents rated the quality of the child's life higher. The appendix stays in to do its natural job and life is good. 

 

I would absolutely recommend probiotics during and after the antibiotic therapy. Resetting the guts balance is paramount to avoiding gut dysfunction and subsequent disease. 

 

This study is an example of medicine and medical research looking out for the patient and the bottom dollar. This is cheaper and better for everyone except the hospital who loses the OR charge. Amen to the research. 


Dr. M

 

Sports Injuries and Prep

Sports Injuries and preparation. Continuing the theme of kids and sports.

Aside from heat and concussion concerns, children in competitive sports are at greater risk for injury because of the contact nature and repetitive motions of sport.

Sports medicine specialists are counseling parents to follow certain protocols to avoid or at least reduce the risk of injury. What can you do?

1) Change up the sport seasonally - this is a point of contention because many coaches want your athlete to focus only on one sport from infancy. I think that changing up the sport allows the body to have differing muscle or bone motion throughout the year that reduces the repetitive motion injury risk. 

2) Stretch daily or practice yoga moves as a way to lengthen ligaments and tendons. 

3) Hydrate - keep the muscles from cramping 

4) Begin training 4-6 weeks before the season starts. This should include daily aerobic activity. 30-60 minutes a day. This way the body is prepared for the rigorous preseason training rituals that begin in earnest every August.

5) Work on post workout recovery. Ice sore muscles with frozen peas for 20 minutes or take a 5 minute ice bath to your entire lower body. 

6) Make sure that all gear is fitted and in place for all training. Helmets, proper shoes and other gear are critical for injury prevention. 

7) Teach proper technique for the sport. Proper technique reduces injury by allowing the muscles to function as intended and this reduces stress. The best example is the throwing motion. If the technique is poor, the elbow stress and shoulder tension is often enough to create pain and then injury. 

8) Eat a healthy diet to support the growing muscles and reduce the inflammation that can follow vigorous sport activity.

Dr. M
 
 
Chemical Experiment
Fastfood Experiment
Week 8
 
Still no appreciable difference. No signs of bacterial or fungal disease. No flies or bugs.

Wonder if the climate control environment of the office has an effect. Plan to start a second test at home in the outdoor environment. Stay tuned.


Recipe of the Week

 

 

 

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Copyright � 2010-2014 Christopher J. Magryta, MD. Readers, please note: The information provided in this newsletter is for educational and informational purposes only. It is not a substitute for advice and treatment provided by your physician or other healthcare professional and is not to be used to diagnose or treat a health issue.


 


Chris Magryta
Salisbury Pediatric Associates
Touchstone Pediatrics