Hannibal Regional’s Post

🌱 Exploring the Surprising Link Between Gut Health and Shoulder Pain As medical practitioners, we often encounter patients with seemingly unrelated symptoms. But what if I told you that a patient's shoulder pain could hold vital clues about their gut health? Let me share a recent success story that highlights this intriguing connection. 🔍 The Case: A patient walked into my clinic with persistent shoulder pain that had been bothering her for months. She also complained of frequent digestive issues such as bloating, discomfort, and irregular bowel movements. At first glance, these symptoms might seem unrelated, but my years of experience and a commitment to holistic patient care urged me to dig deeper. 🌐 Connecting the Dots: I decided to explore the potential link between her shoulder pain and gut health. Research suggests that our gut health can impact various systems throughout our body, including our musculoskeletal system. An imbalance in the gut microbiome can lead to inflammation, which may manifest in unexpected ways, such as joint pain. 🛠️ The Solution: After a thorough examination, I created an ANF Protocol tailored to address both her shoulder pain and digestive issues simultaneously. The ANF protocol uses ANF Devices to stimulate the body's natural healing mechanisms. 🌟 The Transformation: The results were nothing short of remarkable. After just one ANF session, the patient experienced a significant improvement in her range of motion. Her shoulder pain began to diminish, and she regained the ability to perform everyday tasks without discomfort. Equally impressive was the positive shift in her digestive health. The uncomfortable bloating subsided, and her bowel movements became regular and pain-free. The patient was elated by the rapid progress she experienced. 📚 The Science Behind It: Research has shown that the gut-brain axis plays a pivotal role in our overall well-being. An unhealthy gut can trigger systemic inflammation, affecting various body systems, including joints and muscles. By addressing the root cause, we not only relieved the patient's shoulder pain but also improved her digestive health. Conclusion: 🌟 A Holistic Approach to Patient Care 🌟 This patient success story serves as a reminder of the interconnectedness of our body systems. As medical practitioners, we must remain open to exploring unconventional connections, like the one between gut health and shoulder pain. By taking a holistic approach to patient care and harnessing innovative therapies like ANF, we can achieve remarkable results and improve the lives of our patients. Remember, the next time a patient walks in with seemingly unrelated symptoms, consider the possibility of a hidden connection that could lead to a healthier and happier life. #Healthcare #PatientSuccess #HolisticHealth #GutHealth #ShoulderPain #ANFTherapy

The Oklahoman reports ‘…Norman Regional Health System is blaming the diabetes management drug and similar medications, which have soared in popularity because of its effectiveness in helping people lose weight, for the decision to suddenly close its Journey Clinic.’ Journey Clinic has offered medical and surgical weight loss options for the past two decades, will close in 90 days and is not accepting any new patients.  In the past year, weight loss surgeries have fallen by 30%. Norman Regional's CEO Richie Splitt, FACHE said ‘…We've been seeing that decline in volumes over time, which led us to have some very frank conversations and then ultimately to the difficult decision to close the Journey Clinic and bariatric operations.’ Dr. Lana Nelson, DO, director of metabolic and bariatric surgery at Norman Regional noted ‘…that even with the widespread use of cholesterol and heart-health drugs on the market, there's still persistent demand for cardiac surgery.’ And further ‘…Medications will not stop the need for bariatric surgery. Not anytime soon.’ Nelson states ‘…this was purely a financial decision to abandon a program that has been serving the Norman community for 22 years.’ https://lnkd.in/e3r2z9f6

You know you have a cardiovascular system, a digestive and immune system. But did you know that you have a CRANIOSACRAL SYSTEM inside you? Here’s why it may be good to know about it, in case you need it one day. A system is structures that are all involved in carrying out a specific function. Even if you’ve not heard of this ‘system’, you have probably heard of some of its parts:  – the brain and spinal cord, –  the bones of the skull and spine (including the sacrum – hence sacral in the name), –  the layers of connective tissue called the meninges, –  and the cerebrospinal fluid that flows around the brain and spinal cord. So? Well, what cranial osteopaths first noticed back in the day (late 20s and onwards) is that there is a tiny tiny bit of movement in the otherwise-thought-to-be-solid structures of the bones of the head. It’s related to the flow of the cerebrospinal fluid. This flow causes these tiny, tiny, rhythmic movements to occur in the bones of the skull, and all the way down the back around the spinal cord . It can be felt by our hands and has also been measured by specialist laser measuring devices – more on the research another time. They called it the craniosacral rhythm. So we can call it a ‘system’ - just like the cardiovascular system, for example, is made up of the heart, vessels, blood - all the things involved in pumping blood round the body - this system is made of all components that come together to produce this rhythm. Why does this matter? Our health is about our body systems and things inside us working correctly, right? Many of our other systems are monitored, tested and adjusted in various ways in our current medical system. But this system - not so much. And yet, it surrounds our very important central nervous system – the brain and spinal cord – that ‘manages’ our whole body. Luckily, some of us have trained our hands to be able to feel for these very subtle movements. A feat for which we have sometimes been – and still are – ridiculed… But I’ll take that on the chin, knowing how much the this concept has helped me help so many people. Lea was a client a few years back who had had a bad whiplash from a car accident which compounded injuries from a number of motorbike falls. She had low energy levels and mood, poor memory and lots of aches and pains; also a very tight jaw and she had to wear plastic mouth guards at night - which she had cracked a number of times. With so many accidents and injuries her body had tightened up and compensated, so the craniosacral rhythm was less optimal, but with a little bit of help - thanks to knowing about those movements of the bones and deep structures - it began to function a bit better and this changed how she was responding to life. Her words? 'My life force has come back'. So just park it for now, that you too have a craniosacral rhythm, but bear it in mind in case you ever feel the inspiration to check in on it!  

Airway Management in the Morbidly Obese Patient Evaluating and identifying the challenging airway is the beginning of airway management, which is a basic and essential skill of the anesthesiologist. As the incidence and prevalence of obesity increase around the globe, the anesthesia provider will be exposed to a variety of obese and morbidly obese patients presenting for procedures. Obesity does not necessarily equate with a difficult airway. Obstructive sleep apnea (OSA) may be the compounding factor that increases the challenge of any airway. Obesity is a global and continually increasing problem that was first recognized as a disease in 1948 by the World Health Organization. By definition, obesity is the accumulation of excess fat regionally, globally or both, which increases risk to health.1 Another medical group, the Obesity Medicine Association, defines obesity as “a chronic, relapsing, multifactorial, neurobehavioral disease, wherein an increase in body fat promotes adipose tissue dysfunction and abnormal fat mass physical forces, resulting in adverse metabolic, biomechanical, and psychosocial health consequences.”2 According to the CDC, more than one-third of adults in the United States (39.8%) are affected by obesity, which afflicted 93.3 million U.S. adults in 2015-2016.3 Click here to read more: https://lnkd.in/gkPxTprr

Last month, I hosted a Virtual Grand Rounds with Omada Health to answer GLP-1 questions - and we didn’t get time to answer all the audience questions. Here is one: ❓Someone asked: “How do GLP-1s fit alongside other obesity interventions (i.e. lifestyle changes, medications, surgery)? How should we think about the combination of therapies over a plan member's life / time on plan?” ❗This is a great question! What I love about this question is that it speaks to the importance of CHOICE because each person's unique circumstances require individualized care. For patients with a very high BMI, they have several options (all good!) available to them … 🌟 comprehensive lifestyle change with intensive coaching & support 🌟 weight loss medications like GLP-1s, 🌟 a supervised nutrition therapy like keto or shakes 🌟 bariatric surgery. Offering coverage for all these treatments with a medical policy that is based on the research can ensure that you direct the right patient to the right care. For example, bariatric surgery works best for patients who have significant co-morbidities of their obesity and also have tried other treatments. Patients also need to be prepared for the significant behavior change required after the surgery to maintain the impact. Similarly with GLP-1s, certain patients are not good candidates for the medication. There are medical exclusions and also some people cannot tolerate the side effects. Do you have any other questions you want answered? Drop in the comments.

"The quality of our life is determined by the quality of our questions" Today, me and my friend Dr. Amitoj Singh Sidhu got the opportunity to accompany our preceptor, Dr. Praveen Vijhani, to the gym. We began talking about music, sharing our preferences before shifting to the difficulties residents encounter. This conversation naturally led us to the significance of 'WHY' in our lives, and its importance in medical training. Our discussion went onto the Circle of Willis, exploring its formation and branches. We then discussed syncope, the definition, its common causes during pregnancy, and the crucial steps in assessment and management. Our discourse expanded to include differential diagnoses, touching upon situational syncope, orthostatic hypotension, and Postural tachycardia syndrome. We also discussed red flags for syncope in pregnancy and the topic sudden cardiac death. In the middle of our weightlifting session, we pondered the contrast between hypertrophy and hyperplasia. Our curiosity then led us to discuss cath labs - their purpose, and the reasons behind certain preferences, like the right wrist over the groin. We explored the complications of femoral site insertion and the increased susceptibility of the abdominal aorta to atherosclerosis. Our conversation took an interesting turn to cholesterol emboli, laminar flow, Boyle's law, Bernoulli's theorem, and the differences between viscosity and density. We then transitioned to the heart's conduction system. We talked about the initiation of left atrial contraction, interfascicular bundles, EKG changes, Brugada syndrome and atrial fibrillation versus atrial flutter. Then we went to the coronary supply of the heart, the origin and distribution. The topic of palpitations was discussed, along with the role of monitoring devices like holter and implantable loop recorder. By that time, we were relaxing by the side of the pool discussing Bezold-Jarisch reflex, ANP and BNP functions, the origin of life, mitochondria's role as the cell's powerhouse, MELAS syndrome and ATP vs. GTP. Our educational journey didn't stop there. We talked about the charges on DNA and histones, the formation of anti-histone antibodies, the significance of bile, emulsification, causes of NASH cirrhosis, roles of Ito and Kupffer cells, councilman bodies, the importance of Vitamins C and E, and the role of alkaline phosphatase. We even pondered on the existence of acidic phosphatase and its location. As the day concluded, I realized that I had seldom asked 'why' questions before. This experience not only enriched my medical knowledge but also instilled a curiosity in me. I promised to integrate this questioning mindset into my life, recognising that asking 'why' unlocks deeper understanding and encourages learning and I'm confident this approach will help me become a great physician. #USMLE #Step1 #Step2 #Step3 #InternalMedicine #Match2025 #observership #clinicalrotations #USCE #nrmp #DHRhealth #ECFMG #IMG #Criticalcare

Gastroenterology & Endoscopy News recently caught up with Daniel Maselli MD, of True You Weight Loss Atlanta, to discuss our important study highlighting the 3-year impact of the endoscopic sleeve gastroplasty (ESG) in patients with Class III obesity. "At one year, this cohort doubled what we would consider a clinically meaningful weight loss, which is over 10% TBWL. That’s a really meaningful benchmark because that’s the inflection point beyond which we see dramatic improvement in weight-related medical problems like type 2 diabetes, cholesterol, high blood pressure, and sleep apnea," shared Dr. Maselli, an endobariatric physician at True You Weight Loss.  https://lnkd.in/gXX7eAys   #ESG #WeightLoss #ObesityResearch #MedicalAdvancements #Healthcare

In a groundbreaking #study conducted at the University of Pittsburgh School of Medicine, researchers have revealed that #bariatrisurgery proves to be more effective than #lifestyle changes in achieving #diabetes remission, particularly in patients #struggling with #obesity. Published in the esteemed journal #JAMA, the research #challenges conventional wisdom regarding the primary methods for addressing type 2 #diabetes in obese individuals. Typically recommended for those facing challenges in weight loss and battling #diseases associated with #obesity, #bariatricsurgery has now emerged as a more promising approach, particularly for patients with type 2 #diabetes and #hypertension. The study, conducted from May 2007 to August 2013, enrolled participants with #type2diabetes and #obesity, dividing them into two groups for either #lifestyle and #medicalintervention or #bariatricsurgery. The #lifestyle intervention group followed established protocols involving stress management, #medication, support groups, #nutrition tracking, physical activity, and collaborative #healthcareengagement. The results, however, #demonstrated that patients who underwent bariatric surgery experienced more significant #improvements in triglyceride and cholesterol levels compared to their #counterparts relying solely on #lifestyle #modifications. Notably, participants who opted for #surgery reported lower #HbA1clevels, indicative of better #bloodsugarcontrol. The findings indicated that #bariatricsurgery could lead to #diabetes #remission in a #substantial number of patients. A seven-year follow-up revealed that 18% of #surgery participants achieved #diabetesremission, contrasting with the 6% in the lifestyle modification group. The impact #persisted even after a 12-year follow-up, with 19% of surgery patients achieving #weightloss compared to 11% in the medication and lifestyle #modificationgroup. This groundbreaking research #challenges traditional approaches to #diabetesmanagement, showcasing the potential of #bariatricsurgery as a transformative solution for individuals #struggling with obesity-related type 2 diabetes. #News #Medlr #Healthnews #Healthcare #Health

COMING DOWN THE PIKE in Cardiology: Most of today’s cardiology procedures, technologies, & medications were unknown or in their very early stages 50 years ago, and a new Becker’s Viewpoint by UNC cardiology chief Rick Stouffer, MD forecasts that “cardiology will change as much in the next 50 years.” ✔️Here’s the TEN core areas where he expects these changes to take place: 1. Personalized Medicine 2. Environmental Focus 3. Nutrition Focus 4. Cardiomyopathy Progress 5. Specialist Access 6. Chronic Interventions 7. Family Ties 8. Better and Fewer Procedures … but they will “be used less frequently as the focus turns to PREVENTION rather than treatment.” 9. Preventative Weight Loss 10. What WON’T change?  * Exercise will still be prescribed but RARELY followed  * Cheap, non-nutritious foods will continue to be widely available * Patients will continue to engage in behaviors that are detrimental to their health  - People will still die from heart disease. ✅ Coaches, we are & will be needed more than ever. And not just for CV health! See my Cardiac R.E.H.A.B. Fitness Specialist Course at www.medfitclassroom.org. 👍🏔 #personalizedmedicine #predictivemedicine #functionalmedicine Certified Functional Strength Coach MedFit, LLC International Council on Active Aging

This week I'm diving into the research on GLP-1s and how they relate to MSK care. The Docs Who Lift podcast has several great episodes on GLP-1s. I recommend listening to The myths of GLP-1 agonists and GLP-1s and Lean Mass Loss. A couple of notes: These are great drugs for weight loss, preventing progression from pre-diabetes to diabetes, and reducing MACE in at-risk populations. This is a key point. These are not meant for vanity weight loss. GLP-1s are for people with obesity and type 2 diabetes. A big note for MSK providers is the atrophy concerns are overblown. It's not that atrophy cannot happen, but rather, the cause doesn't appear to be anything unique to GLP-1s. GLP-1s lead to a caloric deficit (slowing gastric motility and signaling satiety). If protein intake and resistance training volume are insufficient, muscle atrophy will result. As with any caloric deficit strategy (with or without drugs or surgery), substantial weight loss often leads to lean mass reduction. Studies show sufficient protein and regular resistance training attenuate muscle loss, even when taking GLP-1s. As providers, we should always encourage sound diet and exercise habits, helping the patient maximize their overall benefits. It's not just the scale that improves. Glucose control, inflammatory markers, and lipid profiles all improve, even before weight loss. Help patients meet the physical activity guidelines, which includes two days of resistance training per week, and eat a diet with a lot plants that is high in fiber and protein, by personalizing care and addressing both barriers and facilitators. GLP-1s are not a quick fix and work best as a comprehensive treatment plan that includes resistance training. They are highly effective drugs that can help people with chronic disease (obesity, CVD, diabetes). When used in this population, they are not a cop-out, cheating, or a sign of laziness. They are a drug that can help someone improve their overall health. Here are some resources to learn more: https://lnkd.in/eg_h-h-4 https://lnkd.in/ekByQZ8z https://lnkd.in/eZEhb35V https://lnkd.in/ehENW6Xw https://lnkd.in/esMXGXBi https://lnkd.in/eBaKAD3v https://lnkd.in/eQyuzXwW https://lnkd.in/eVJr24uh https://lnkd.in/eUPvwWub