Dear Dr. Gott: I read your column every day in my local Arkansas paper. Your recent column talked about the antioxidant vitamins C and E; however, nothing was mentioned about the most powerful one of all — glutathione — that we were born with and decreases with age. Can you discuss this little-talked-about antioxidant?
Dear Reader: Glutathione is reported to be the body’s master antioxidant. It is produced in the liver and plays an important role in metabolism. It is composed of cysteine, glutamic acid and glyceine, and is purported to help human cells function normally. It is found naturally in numerous meats, eggs, fruits and vegetables, such as asparagus, broccoli, avocado and spinach, unprocessed whey protein and milk thistle; however, the absorption rate of glutathione from all food sources in the gastrointestinal tract of humans is apparently low.
It has been used for the treatment of heavy-metal poisoning, to increase the effectiveness of drugs for chemotherapy given for breast cancer, in lowering blood pressure in patients diagnosed with diabetes, for the treatment of Parkinson’s disease and a great deal more. Research projects for ALS, cancer, cystic fibrosis, asthma and a number of other conditions are under way with this antioxidant to investigate its potential for boosting the immune system, improving longevity, reduce chances for developing cancer, improving mental, heart and lung function, and increasing energy.
While marketed as a nutritional supplement, there is little documentation to support the theory it actually increases levels within cells. In fact, in human studies, oral doses had minimal effect in raising blood levels. Supplemental vitamin C is reported more effective in increasing intracellular glutathione than the supplement is.
Levels within the human body decrease with age, presumably at a rate of 1 percent per year after the age of 20.
I’m not sure that I will rush out to my local pharmacy in the rain today for a bottle of glutathione, but never say never.
Dear Dr. Gott: I’m an 87-year-old woman with
a circle about the size of a quarter on my right thigh, about four inches above my knee. All the skin around it is very smooth, but it is rough to the touch and appears to be flaking. Sometimes it is pale pink; other times it is an angry, dark pink. Occasionally, it itches. Neosporin and other creams don’t help. Can you?
Dear Reader: I don’t know without seeing it, but my first thought is eczema or psoriasis. My recommendation is that you see your primary-care physician or a dermatologist for a diagnosis. Once the lesion is examined, appropriate medication can be prescribed.
While you are waiting for your appointment, be sure to keep your skin moistened. Treat the area with a petroleum-based product. If you bathe in a tub instead of shower, add Epsom salts or bath oil to the water.
Dear Dr. Gott: First, I want to say that I’ve been a fan of yours for a long time. Then I want to tell you it makes me furious to have everyone assume that a person who has herpes has been promiscuous.
I, too, have herpes outbreaks at a spot on my buttocks, and there is no doubt in my mind where I got it — at the hospital.
Having been monogamous for at least 12 years at the time, I had to have emergency surgery, and the herpes popped up within a week of discharge. The outbreak was exactly where I got all my pain shots. The location migrates just a bit every time it crops up, but it’s never been anywhere close to my genital area, thank heavens. A friend of mine also says she got herpes in the same hospital, years earlier. We’ve been friends for 30 years, and I just found that out last year. Her outbreaks are on her inner thigh, much closer to her knee than to her genitals.
I hope this makes some of your readers feel better.
That said, I want to recommend nail polish to your readers. The dermatologist I went to (because I did not know what the “rash” was) gave me pills and cream that upset my digestive system, so I tried what I use on anything that itches — clear nail polish! Applied three or four times a day, the outbreak will usually be gone by the third day.
Dear Reader: Thank you for sharing your experience. There are a number of different forms of herpes (80, to be exact), referred to as herpes simplex virus 1 (HSV-1) and herpes simplex virus 2 (HSV-2).
HSV-1 can cause genital herpes but more commonly causes infection around the mouth and lips, as in fever blisters. Other areas of the body can be affected, but that’s uncommon. HSV-1 is caused by the herpes simplex virus, and is estimated to be present in up to 80 percent of the entire American adult population. Both HSV-1 and -2 can be released from the sores the virus causes but is also released between outbreaks from clear skin that doesn’t appear to be affected at all.
Genital herpes most commonly results from HSV-2. It is estimated to be present in up to 20 percent of the American adult population.
Oddly enough, many people are completely unaware they even have this sexually transmitted disease because it can remain dormant in the system for years. Transmission of HSV-2 occurs during sexual contact with someone who has the infection, who may not have a visible outbreak and who may be completely unaware he or she is infected.
You are correct in that the herpes virus can be contracted in a hospital setting. The most common site is the delivery room, where an infected mother may transmit the virus to her infant at the time of delivery.
Treatment, as you were likely prescribed, consists of antiviral medication. I must admit that you have opened up another avenue with the use of clear nail polish. My guess is, it acts as an occlusive dressing and keeps the air and moisture from reaching the open-wound site. I have never had anyone else tell me that HSV can be controlled through this method, but if it works for you without unwanted side effects, I guess you should stick with it! Thank you for sharing the information.
Dear Dr. Gott: Does a patient have the right to question his or her medical records without retribution? I questioned my records after finding errors in them with the doctor’s head nurse. She corrected some of them but said she would have the office manager contact me in regards to other errors. The office manager refused to call to discuss my concerns.
For example, I got turned down twice for long-term-care insurance because my records were not up-to-date and accurate. As a matter of fact, the head nurse told me that my records had not been updated in three or four years. My records indicated at one time I had congestive heart failure, which I never did. They coded my wife’s blood work with my identity. These are only a few examples that I discovered. I am sure there were more that I was unaware of.
I sent several emails and made a phone call to the doctor’s office to follow up with me to talk about correcting my records. No correspondence back, so I requested the doctor call me and even set up a one-on-one appointment to resolve the issues at hand. WOW! What did I do that was wrong? Was I not supposed to question my records and have then updated and accurate? Apparently not. I did finally receive an email from the office manager, stating, “It appears from your concerns and multiple emails that the patient/provider relationship has been damaged and that an issue of distrust has now been established, and that this notice will serve as termination of our patient/doctor relationship for both you and your wife.” They will provide emergency medical care and prescription refills for 30 days. We need to find a new physician, and they will forward our records to them.
I was content with the service the doctor provided my wife and me. I was not questioning his ability and knowledge, nor did I distrust him as a doctor. I was concerned that my medical records were not accurate and were outdated. I was not happy with his staff that my records were inaccurate.
What is your expert opinion and advice on all of this?
Dear Reader: To begin with, I am appalled. How on earth can records be outdated by three or four years? Was everything recorded on a machine and the staff simply hasn’t had sufficient time to transcribe the information? Did your doctor write notes every time you had an office visit, or was some other method of documentation instituted? From where did the congestive heart failure originate? Were your records mixed up with someone else’s who might share your name? Really, where can you honestly put the blame? Do you think you are the only person in his practice who has this problem, or are other charts lacking current information and full of errors as well? My guess is that you have opened a can of worms that truly requires immediate follow-up.
If your doctor is relying on his staff to record vital information, someone has fallen down on the job, and it’s critical he be advised; after all, the ultimate responsibility falls on him. Perhaps he is completely unaware of the situation and just gave his staff a big pay raise when a more appropriate course of action might have been to investigate and, if justified, fire the person responsible. Medical records are serious business.
The only way to be prepared for an incoming patient is to review the record to determine why he or she was last in, what the situation was, what medications were prescribed and the reason for the present appointment. If a seemingly young man is reported as having a bad ticker without justification, steps must be taken to correct all misinformation. What if a cardiac medication was prescribed to you and you didn’t take the time to question it? Talk about scary! Perhaps somebody simply wrote notes in your chart that should have been included in someone else’s notes. Errors occur and accidents happen, but plain stupidity is unacceptable!
For your own well-being, I would find a new physician immediately and have him or her (with your signature for documentation) request your records. Then write to the physician via certified mail, return receipt requesting his signature, that you found it necessary to leave a practice you enjoyed because of his inept staff. Then inform your state medical board in writing of the situation. Keep it civil, but outline everything. Hopefully an investigation will follow. Good luck.