A New Hope for Painful Diabetic Neuropathy: An Interview with Dr. Richard P. Winne

Antibiotic Use May Now Be Linked to An Increase Risk of Colorectal Cancer PART II

By Louisa Emhof

Antibiotics have become an everyday part of the medical world. They are used to fight bacterial infections and have saved millions of lives worldwide since their discovery. If you’ve ever had a bacterial infection, you're probably already pretty familiar with antibiotics. However, the prevalent overuse of antibiotics is leading to some serious unintended consequences.

Although there have been remarkable benefits that antibacterial use has brought about, there is a dark side to it as well, such as an increased risk of colon cancer. Another problem that the overuse of antibiotics causes is antimicrobial resistance, which causes more dangerous forms of bacterial illnesses. Still, there’s no time to despair! Medical professionals and researchers are working hard to find alternatives to antibiotic treatments.

The Risks of Antibiotic Use

Antimicrobial resistance, caused by the overuse and misuse of antibiotics, is one of the reasons that finding alternatives to antibiotic use is wise. Their life-saving effectiveness causes physicians and patients alike to rely heavily upon antibiotics, even for common bacterial infections. An example of the misuse of antibiotics is when they are prescribed for non-bacterial illnesses like colds and the flu. However, sometimes antibiotics are still prescribed for this. The overuse of antibiotics led to antimicrobial resistance by creating bacteria that are not affected by the medicine.

Another big antibiotic-related concern is the link to increased risk of colon cancer. Colon cancer is the second leading cause of cancer-related deaths in the United States. Rates of antibiotic use have skyrocketed since the 1980s, and scientists have also reported an alarming rise in colon cancer rates. What is especially concerning about this increased risk of cancer is that it affects people younger than 50 at a disproportionate rate.

Additionally, a study found a "dose-dependent" aspect to the link between antibiotics and colon cancer. Essentially, this means that the different kinds and doses of antibiotics you take impact your risk level. So what's the solution here? Doctors, medical professionals, and researchers have been working hard to discover alternative ways to treat bacterial illnesses to avoid antibiotics' harmful effects.

The human body has many good bacteria in it that the antibiotics can't differentiate from the bad ones. This affects the balance of the microbiome in your gut and could be the link between the potentially cancer-causing aspect of antibiotics. Protecting the good bacteria in your body is essential, which is why looking into alternatives to antibiotics is a great way to approach your health.

The Most Advanced and Promising Alternatives to Antibiotic Use

Alternatives to Antibiotics

The good news is that medical professionals are becoming increasingly aware of the negative repercussions of antibiotics misuse and overuse and are rigorously testing out replacements. Some of these different approaches to bacterial infections were used in ancient times. Ancient medical techniques that involve natural elements like clay and minerals are being studied because of how extensive their antimicrobial activity is. Just as researchers are taking note of more unconventional and ancient methods, they are also delving into new fields of research and technology. Lastly, vaccines are an outstanding scientific and medical invention that trains your body's natural immune system to recognize and neutralize foreign threats in small or benign doses so that your body can better handle the real thing. Your immune system essentially memorizes how to deal with an imitation of an infection and is then prepared to fight off the actual illness.

These three are the most advanced and promising alternatives to antibiotic use. However, while we are still developing and researching these replacements, basic and reasonably limited antibiotic use will still need to happen.

One potential alternative method involves using what are called bacteriophages. Bacteriophages, or phages, as they are often called, are naturally occurring viruses that target and kill bacteria. If you think about it, they accomplish the same thing that antibiotics do! This is why they are serious contenders for replacements for antibiotics. reign substance, antibodies retain that information and protect the body against future infection.

A Parting Reminder

Our Top Doctor Magazine team hopes this overview equips you with fresh knowledge on the potential dangers of antibiotic overuse and misuse. Now you can feel comfortable discussing different options with your doctor! Ask your doctor if you have any questions about whether you should be using antibiotics or an alternative method.

Drinking and Smoking while Young Could Age Your Heart

B Y I O N U Ț R A I C E A

The teenage years are the threshold when we form our personalities for the future adult life. It is also the time for once-in-alifetime experiments, when we take a shot at all-known vices with a just-once mentality. Such endeavors, of course, are always risky, considering that most of our adult vices stem from our teenage years. "Just once" can quickly turn into "forever. "

Out of all vices, drinking and smoking are the adolescent favorites, although secrecy doesn't allow us to grasp the severity of the situation. In 2019, almost 25% of people aged 14 and 15 had at least one drink, and in 2020, 4.5 million teenagers consumed tobacco products, especially e-cigarettes. Although one sip of alcohol doesn't cause addiction, one cigarette is often enough to get hooked, which is no wonder why 200 young Americans turn experiments into addiction daily. Social pressure, the link between smoking and AOD (i.e., alcohol and other drugs), and a precarious understanding of addiction lead our nation's youth to adulthood with medical problems.

Teenagers rarely ponder the immense workload that organs have to put in to keep up with their vices. Your body's engine, the heart, beats about 100,000 times per day and delivers blood through a network of vessels long enough to circle the Earth four times! Such a Herculean effort does not leave room for error or unhealthy lifestyle choices. Unfortunately, our conscious sabotage leaves marks on the cardiac system, especially in the arteries. Did you know that a smoker and drinker's arteries can significantly stiffen from a young age? Keep reading below to find out more.

The Effects of Smoking and Drinking on the Human Body

Every mosaic loses its grandeur once enough people have stepped and caused the little pebbles to lose their color. Once a single pebble fades, the whole mosaic becomes incomplete. Drinking and smoking have the same effect on the human body, although multiple organs live with the consequences. The liver, the pancreas, the brain all have to suffer such faulty choices, not to mention the weakened immune system and the increased risks of certain cancers. Basically, we consciously sabotage ourselves without receiving anything in return.

But the most alarming drinking and smoking threats to our bodies have to do with the cardiac system. Both vices are linked with different forms of cardiovascular disease (or CVD). For example, indulging in more than three drinks per day enhances the risk of ischemic stroke (i.e., caused by blood flow deficiency) and myocardial infarction (i.e., heart attack). Furthermore, smoking, regardless of form, adds insult to injury by increasing the chance of congestive heart failure, hemorrhagic stroke (i.e., bleeding in the brain), and arterial disease.

Although young drinkers and smokers believe they can kick these vices before suffering from any medical issues, the truth is, they might already be suffering the consequences, especially in their arteries. Research has proved that even mild alcohol and tobacco consumption can cause arterial stiffening, therefore setting teenagers on a course to CVDs. The remaining questions are, "How far is the arterial stiffening process? and "How can we reverse the process?"

Typically, as the aging process kicks in, our arteries naturally lose their elasticity. However, drinking and smoking heavily influence the speed at which the stiffening process develops. Therefore, the further teenagers indulge in these vices, the more the CVD risk increases.

Researchers from the UCL have shown that teenagers who drank more than 10 drinks in a typical drinking day had a 4.7% increase in arterial stiffening than "light" drinkers (i.e., less than three drinks). At the other end, high-intensity smokers (more than 100 cigarettes ever) had an arterial stiffening increase of 3.7% compared with lightintensity smokers. However, at the top of the ladder sit teenagers who heavily indulge in these two vices, whose arteries thicken 10.8% faster than those who "stay clean. " Although slight in the short run, these percentages can prove troubling at a later age, when arterial stiffening gives rise to other CVDs.

How Can Teenagers Reverse Arterial Stiffening?

However, the battle is not yet lost. Vices do leave a stain on our health, but all stains can be removed with proper care. The researchers who conducted the Avon Longitudinal Study of Parents and Children (ALSPAC) in the U.K. encourage teenagers to bid smoking and drinking goodbye and embrace a healthy lifestyle. Professor John Deanfield, one of the ALSPAC researchers, affirms that "If teenagers stopped smoking and drinking during adolescence, their arteries returned to normal. " And the benefits don't stop there -- ex-smokers frequently cite improved breathing, appetite, sleep, taste, and smell as short-term benefits of kicking this habit, not to mention the improved cardiac function and blood flow that follow suit. So there's no better time to defeat these vices right now, during the teenage years, while the body still preserves its miraculous healing capabilities!

Your Body Is Your Temple Worship It!

Here at Top Doctor Magazine, we advise teenagers to spend their precious adolescent years healthily, without resorting to vices for social recognition. From personal experience, ex-drinkers and ex-smokers can testify that these vices are nothing but parasites who take your energy and health away without giving anything helpful in return. Therefore, we hope that our young readers will ponder the implications of their decisions before lighting another cigarette or ordering another pint and settle up with these vices forever.

An Exclusive Interview with Dr. Richard P. Winne

By Gaye Newton

A New Hope for Painful Diabetic Neuropathy: An Interview with Dr. Richard P. Winne

If you are struggling with nerve pain, you may feel like someone is following you around, randomly jabbing you with a needle. Maybe you ache all day or don't sleep well. It's difficult to lead an everyday life when your daily flow is constantly brought to a screeching halt by a jolt of sharp pain. For many people with diabetes, painful diabetic neuropathy (PDN) can be annoying and frustrating at best, disabling at worst.

Board-certified in pain management and anesthesiology, Dr. Richard P. Winne, Jr., MD, shares with us his insights into neuropathy and its treatments. He is one of the most sought-after doctors for an uncommon condition known as Complex Regional Pain Syndrome (CRPS), also known as Reflex Sympathetic Dystrophy (RES). This is a painful neuropathic condition that can require a great deal of treatment by a very knowledgeable and experienced doctor and team.

Dr. Winne’s dedicated team provides the full spectrum of pain care—medical, psychological, physical, and interventional services, including spinal cord stimulation. To ensure the complete care their patients need, they also work closely with neurosurgeons, orthopedic spine surgeons, physical therapists, an acupuncturist, a psychologist, and nearly every other kind of medical specialist. Recently Dr. Winne discussed with us an exciting breakthrough device that can bring a new level of pain relief. This spinal cord stimulation device, called HFX, was approved by the FDA with a specific indication for treating PDN.

Painful Diabetic Neuropathy

Neuropathic pain is caused by damage within the nervous system - the nerves, spinal cord, or brain. The effects of neuropathic pain are not just physical; they can trigger depression and anxiety, which, in turn, can exacerbate the pain.

Diabetes brings on a host of complications. The American Diabetes Associates states, "about half of all people with diabetes have some form of nerve damage. " PDN can be one of the more debilitating conditions to live with and manage, and, until recently, there have been few effective treatment options beyond medications, which don't always produce the desired results.

However, Dr. Winne is quick to point out that not all diabetic neuropathy is painful neuropathy, and that PDN is located in the peripheral body areas, mainly arms and feet. “They can get all kinds of problems from diabetic neuropathy, but it's not painful. So we don't do stimulators if you have a fast heartbeat from diabetes because your heart nerves are affected by your diabetes, which happens, or your bowels don't work as well because you're nourishing. That's all diabetic neuropathy, but it's not painful peripheral neuropathy -- that's the difference, ” he says.

Symptoms

Caused by long-term high blood sugar levels, PDN may bring mild symptoms or be extremely painful and debilitating. Depending on the nerve damage, it can affect almost any part of the body, from head to feet, and cause sharp pain, numbness, digestive illness, vision trouble, and problems with various organs and systems. Symptoms can intensify without treatment.

Treatments

Currently there is no cure for PDN. The goals of treatment are to slow its progression, address complications, alleviate pain, and improve the patient’s ability to function. You can take steps to prevent, delay, improve, or slow the progression of nerve damage, such as controlling blood sugar levels and blood pressure, surgery that destroys pain-causing nerves, or medications that provide widely varying degrees of relief.

Some patients benefit from physical or occupational therapy. And then some forms of injections can be utilized to help reset the sympathetic nervous system, so it behaves more normally--a sympathetic blockade. You turn off the sympathetic nervous system for a brief time, which allows that nervous system to reboot. Dr. Winne describes this process more clearly through a computer analogy -“Just like if your computer wasn't working properly, you just turn it off, turn it back on, and somehow it reboots properly. Same thing with neurosis. ”

Dr. Winne recommends spinal cord stimulation as a long-term solution. He further explains to us how electrical impulses interrupt pain signals with a very relatable example. “Say you hit your head on a desk, right? And then you pull away, and you rub it. It feels much better, which makes no sense, right? Because you just smashed it; now, you're rubbing it. Why does it feel better? Because when you rub it, you're activating the nervous system to help inhibit the pain signals. So you actually turn on that part of the nervous system that inhibits pain, and that's what the stimulator does, is it stimulates a spinal cord to turn on and activate a part of the nervous system, which pivots pain being felt, ” he says.

New Treatment

An extremely important recent FDA approval was just announced authorizing spinal cord stimulation (SCS) for the treatment of painful diabetic neuropathy. We expect this to help the lives of thousands. Dr. Winne’s enthusiasm is apparent, as this new device may alleviate nerve pain more effectively and reliably than previous methods. Nevro Corp, a medical device company, received FDA approval for HFX, its Senza system for treating chronic pain associated with PDN. Approval was based on the system's demonstrated safety and efficacy in the SENZA-PDN trial published in JAMA Neurology.

It was shown that high-frequency, or 10 kHz, SCS is safe and effective for people suffering from extreme pain and for those whose medication does not provide the necessary relief. After a year, patients reported clear, sustained benefits--less pain, improved sleep, and better quality of daily life. This may mean that some patients can leave their mediations (and accompanying side effects) behind.

PDN can now be treated with stimulators, which Dr. Winne has been doing slightly in the past. As he tells us, “Now, painful diabetic, peripheral neuropathy has been studied and now approved to be treated with stimulators, which we've kind of been doing a little bit over the years, and I've been talking to various patients about doing it, but it's never been fully approved. Not that we can't do it, not that Medicare wouldn't pay for it, but now they (i.e., Medicare) definitely will. ” This is excellent news to patients who desperately need this treatment.

How It Works

Here’s a quick summary of the device's ultimate goal: When you stick this wire in someone's back, you stimulate the spinal cord, and that inhibits their pain. Delivering 10,000 electric pulses per second, HFX does not allow the painful sensation to be relayed up to the brain.

The use of HFX begins with a test. Before implantation, the wires are temporarily placed on the intended spot on the body and connected to an external control box. You can test it for one to two weeks in order to see how it feels and if you like it.

Unlike surgery, HFX is minimally invasive and totally reversible. If the pain improves within a few years, patients can have the system removed. HFX may be a viable option for people with nonoperative conditions or who are too ill for surgery. “If an 85-year-old lady who is not a good surgical candidate, either because her disease is too extensive or she’s too ill, that spinal cord stimulator is certainly a lot less than basic procedure and option for her, ” explains Dr. Winne.

Conclusion

The HFX device brings a new level of hope to people with diabetes. It puts into play a powerful new weapon against the debilitating effects of painful diabetic neuropathy.

We thank Dr. Winne for sharing with us his expertise in the world of neuropathy management, and we appreciate his dedication to giving his patients as many pain-free moments as possible. With the new HFX device in their arsenals, physicians now have more options to manage patients' pain and offer them a much-improved quality of life.

Telehealth, It’s Come A Long Way!

By Melissa Blatt, CEO of indipop

Telehealth has been around a lot longer than you may think. The pandemic has made telehealth and telemedicine more of a household word as physicians limited patient’s in-person visits out of concern of spreading Covid-19. Since 2020, virtual visits have become the norm and adding a blood pressure kit, oximeter and improved electric thermometer to your Amazon cart has happened for almost all of us. But did you know that telehealth first appeared in the 1940’s through telephone lines? And with the advancement of the motion picture industry came the technology that influenced today’s video medicine.

In addition to platforms like Skype, and Zoom for health, there are many new HIPAA compliant technologies that enable you to speak with your provider via computer, phone or tablet almost anytime, day or night. This round the clock availability provides you with access to a healthcare provider at those times of day previously regulated to an “urgent care” or emergency room visit.

Dr. Janice Johnston, MD, Chief Medical Officer and Co-Founder of Redirect Health tells us that telehealth allowed her to diagnose and treat conditions virtually that range from pink eye to managing someone’s glucose levels. “Telehealth has benefited the person with open access but also meaningful follow up. ” says, Dr. Johnston. A patient that met with her at 2p.m. could follow up that evening if the symptoms got worse.

This ease of connection offers great relief to both patient and caregiver, as no one has to be untethered from the care they need.

If things get worse, a Redirect Health provider can schedule a virtual follow-up visit to determine the best next steps, coordinate care at the local hospital or urgent care clinic and then alert the facility when the patient is on their way.

The New Approach to Managing Medical Needs

Redirect Health makes healthcare work with a people-first approach to care, offering access to streamlined, affordable healthcare. Redirect Health combines physician expertise via the company’s own employed staff, easy-to-use technology and pro-active population health to bring transparency to care and cost.

It works like this: if you wake up with a sore throat, instead of calling your primary care doctor or heading over to the urgent care, a patient uses the Redirect Health app or care number. A concierge team speaks with you as a person, not an ID or group number. They ask what your symptoms are and help guide you to the best care. You may have a virtual visit with a provider or perhaps it will be to order your lab work. If that is the case, you’ll head directly to the lab and then have a follow up visit to go over results.

This is all included in the monthly fee. You are not limited to the number of times you can speak with a provider and don’t have to worry about co-pays, deductibles and excessive time spent with a provider. It’s all part of the standard plan.

The big difference is that, instead of stepping into a doctors office, you are in the comfort of your own home. Your providers are dressed just like you, so no white coat syndrome. They want you to feel as comfortable as possible and not rush you out the door. If your telehealth plan is like one from Redirect Health, your provider is equipped with your medical history, current and past medications and has any on hand notes from past appointments, all to help you get the best care possible.

If you were seeing a traditional doctor or lab, the time spent traveling to different offices alone would have taken significantly longer and could have amounted to weeks of lost time. Telehealth makes it possible to have a virtual visit and start treatment almost immediately without needing to go to the ER or urgent care. This basic difference saves time, money, offers faster relief and more complete answers to you.

Benefits of Managing a Chronic Condition

What about chronic conditions like diabetes or thyroid conditions? A telehealth provider can help monitor your health with lab orders to stay on top of your levels and have a direct contact to check in with you 24/7.

Covid-19 is a perfect example of how telehealth can be a lifeline when you are battling an unknown virus. Each case is so different, one minute you are breathing fine and the next minute gasping for air. A telehealth provider can assess your symptoms virtually by watching how you speak, cough and your appearance to make quick decisions about the care you need. They are also there throughout the night to contact if any new symptoms may arise and can prescribe the medications that may be necessary to get you feeling better again.

Healthcare can have many Barriers and Cost Shouldn't be One of Them

Far too many people get concerned when they see their provider and the visit calls for additional procedures and tests. If you don’t have a comprehensive insurance plan and/or if you are self-pay, the unknown costs can cause you to hesitate. What will the tests cost? How many will there be? What other unknown procedures are lurking around the corner? If you have ever been in this situation, you know it can feel scary staring at an open bill. Unfortunately, some people stop their treatment at this stage for this very reason, resulting in prolonging your symptoms and extending the time to start the healing process.

It’s important to note not all physicians are aware of the cost of medication or tests. On a telehealth plan, your provider can often begin with just one or two items on a bigger list to see if the first tests/procedures bring relief. The ease of frequent check-ins allows for easier connection between patient and provider and eases the stress of waiting for appointments and additional cost associated with it.

Telehealth, an Option to Explore

Inquire with your insurance if they offer a virtual service. If they do not, you can find plans out there that offer telemedicine services and have regular open enrollment so you can sign on as a member and have access to their providers. Consider your lifestyle if you think this may work for you. Services like Redirect Health are a great option if you have children because no one wants to get out of their comfy bed at 2a.m. to go to the ER for their 5 years old’s rash or upset tummy.

Remember as you look at plans to be sure and include the following items:

The pandemic may have propelled virtual medicine into our lives, but the quality and access to care will launch this service into the mainstream soon. The good news is that this shift will improve the healthcare experience for everyone, not just people who are on specialized plans.

Ability to see the same provider multiple times Available 24/7/365 Easy access to health history once you have provided it

A Word from indipop Founder & CEO, Melissa Blatt

In 2019, I left the corporate world to start a new chapter in my life. I craved the freedom offered by working with clients and projects that sparked my interest. I knew being self-employed would be a challenge, but I did not expect the sticker shock I found when it was time to look for healthcare. I could not afford the COBRA plan and became deeply frustrated with the options I found.

I was worried about the “what if” scenarios and knew I wasn’t alone – 57 million Americans are self-employed, or what I like to call the “Independent Population.

I found my solution in healthshares. Although not mainstream, they are a different approach to managing medical needs, with fair medical pricing, concierge care and lower monthly rates. I created indipop because I want to offer you the same solutions. Then, you too can be free to do your best work and pursue your dreams, without worrying about “what-if” scenarios.

I’m excited that you’re here and exploring an important alternative to traditional health insurance. I want to personally invite you to review our handpicked plans so you’re prepared for the expected, and unexpected, medical needs in life.