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  • Show 1492: What Really Works Against Winter Infections

    Show 1492: What Really Works Against Winter Infections
    Oct 23 2026
    We are only about a month into fall, but flu season is already underway. Today we are considering the best actions to take against winter infections. First, however, we asked our guest expert about measles. There have been large outbreaks in so many places this year. Why is measles such a big deal? One reason is that measles induces “immune amnesia,” so that our bodies forget how to fight off infections they have previously overcome. The MMR vaccine for measles, which prevents infection extremely well, does not have the same deleterious effect on the immune system. Consequently, vaccinated people maintain their protection not only against measles but also against polio or diphtheria if they have gotten those immunizations. At The People’s Pharmacy, we strive to bring you up‑to‑date, rigorously researched insights and conversations about health, medicine, wellness and health policies and health systems. While these conversations intend to offer insight and perspective, the content is provided solely for informational and educational purposes. Please consult your healthcare provider before making any changes to your medical care or treatment. How You Can Listen You could listen through your local public radio station or get the live stream at 7 am EST on Saturday, October 24, 2026, through your computer or smart phone (wunc.org). Here is a link so you can find which stations carry our broadcast. If you can’t listen to the broadcast, you may wish to hear the podcast later. You can subscribe through your favorite podcast provider, download the mp3 using the link at the bottom of the page, or listen to the stream on this post starting on Oct. 26, 2026. What Really Works Against Winter Infections? Our guest, Dr. Roger Seheult, is certified in pulmonary and critical care medicine, as well as internal medicine and sleep medicine. So he is eminently qualified to tell us how to prevent and treat respiratory infections that are so common in the wintertime. We asked him why these problems are so prevalent in winter. He suggested that lower levels of humidity, temperature and sunlight might all play a role. When we asked whether the phenomenon of people gathering from across the country for Thanksgiving and Christmas might be important, he pointed out that Australians also gather for Christmas and New Year’s. Yet their flu season does not coincide with those holidays, but rather with their wintertime in June and July. Limited sunlight might be far more relevant than most of us imagine. The immune system is more active when exposed to sunlight. As with measles, where the immune amnesia is a serious lingering problem, the consequences of many winter infections can go far beyond coughing and sneezing. More people die from heart attacks during flu season than at other times of the year. In fact, there are more cardiac deaths than deaths from influenza. Other infections also have deleterious impacts on the rest of the body systems. As we learned during the pandemic, COVID-19 can trigger diabetes. Consequently, we ought not dismiss these infections lightly. Testing for Winter Infections In the hospital, when Dr. Seheult and his colleagues admit a patient, they test to see what type of infection has made the person so sick. Most of the usual infections produce similar symptoms: cough, congestion, runny nose, fever, wheezing and body aches. Body aches are more common with influenza than with colds, but there is a significant overlap in symptoms that makes it hard or impossible to diagnose based on clinical appearance alone. To treat inpatients, doctors first test them. The test will reveal quickly which of 13 different viruses have made the patient ill. Sometimes, more than infection is contributing to the misery. While we do not have access to such sophisticated tests at home, we can purchase tests that will identify COVID-19, influenza A and influenza B. Knowing what infection is causing trouble can help a doctor prescribe a treatment, if there is one. Treating Respiratory Infections Once the physicians have identified the cause of the infection, they can determine if there is a treatment. There are a few for influenza A. Perhaps the best known is oseltamivir (Tamiflu). However, while Tamiflu have been shown to shorten the duration of the flu, Dr. Seheult cautioned us not to expect too much. Taking Tamiflu can shorten the duration of the flu from about a week to roughly six days, on average. For many other infections, we do not have effective treatments. Influenza B, for example, does not respond well to Tamiflu. There are no treatments for infections like human metapneumovirus either. Tapping the Power of Fever What people often do in such cases may be counterproductive. Very often parents give their children acetaminophen to bring a fever down. Adults may take an NSAID such as ibuprofen or naproxen, or perhaps they too will take acetaminophen. That is a mistake because fever is part of the body’s ...
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    1 h et 1 min
  • Show 1491: Would Eating Better Reduce Brain Fog?

    Show 1491: Would Eating Better Reduce Brain Fog?
    Oct 15 2026
    Do you run out of go-power in the middle of the morning? Maybe you find it hard to focus and your ability to call on your memory is strained. Or perhaps you suffer from an after-lunch slump. Some people find that their brain fog is troublesome most of the time. While there are some medical conditions that produce brain fog, you just might find that changing what you eat could help your mental clarity and reduce brain fog. At The People’s Pharmacy, we strive to bring you up‑to‑date, rigorously researched insights and conversations about health, medicine, wellness and health policies and health systems. While these conversations intend to offer insight and perspective, the content is provided solely for informational and educational purposes. Please consult your healthcare provider before making any changes to your medical care or treatment. How You Can Listen You could listen through your local public radio station or get the live stream at 7 am EST on Saturday, October 17, 2026, through your computer or smart phone (wvtf.org). Here is a link so you can find which stations carry our broadcast. If you can’t listen to the broadcast, you may wish to hear the podcast later. You can subscribe through your favorite podcast provider, download the mp3 using the link at the bottom of the page, or listen to the stream on this post starting on Oct. 19, 2026. How Could Eating Better Reduce Brain Fog? Our guest, Dr. Uma Naidoo, is a leader in nutritional psychiatry. She found in her practice that what people eat can make a big difference for their mood and even their cognition. Breakfasting on coffee and donuts is often a preamble to needing (not just wanting) a coffee break mid-morning. Evidence has been growing that people may perform differently depending on the type of breakfast that they had. This could well vary from one person to the next. Some thrive on a bowl of steel cut oats with yogurt and berries, while others notice that it doesn’t carry them through the morning. Dr. Naidoo suggests that in most cases a low-carb breakfast with plenty of protein will serve us better than the typical Danish and coffee. The Impact of Sugar on Cognitive Health A fascinating study published earlier this year demonstrated the surprisingly persistent effects of consuming sugar. The investigators took advantage of a natural experiment occasioned by the rationing of sugar during and after World War II (NPJ Aging, July 22, 2026). They compared people born between 1951 and 1956. Some of these were exposed to sugar rationing only while in utero, some were exposed to it in utero and up to age two, while the third group was conceived and born after sugar rationing had stopped. Those babies are now in their 70s. Those with their first thousand days under sugar rationing have dramatically lower risk for developing dementia–a 27% lower risk for any type of dementia and a 46% lower risk for Alzheimer disease. We don’t have any studies showing that limiting sugar in adulthood can benefit the brain in the same way, but the evidence we do have suggests eating less sugar might reduce brain fog. Is Your Medicine Causing Brain Fog? When psychiatrists prescribe pills to treat depression, anxiety or other mental illnesses, they are aware that one of the effects might be confusion or lack of mental clarity. These are not the only types of medication that can cause trouble, though. Many people rely on over-the-counter sleep aids night after night. Nearly all of these contain diphenhydramine (DPH) as their active ingredient. DPH counteracts the activity of a neurotransmitter called acetylcholine. As a result, pharmacologists classify it as an “anticholinergic” drug. Even by itself, but certainly in combination with other anticholinergic medicines, DPH can lead to brain fog. If you are interested in exploring what those other anticholinergic drugs are, you will find a list here. The Insomniac’s Dilemma Many people who frequently have trouble sleeping feel like they’ve been put between a rock and a hard place. To function at their best, they need adequate sleep. But the sleeping meds they rely on, whether they contain DPH or a Z drug like zaleplon (Lunesta), zolpidem (Ambien) or eszopiclone (Sonata), may lead to next-day fuzziness or eventually chronic brain fog. When possible, lifestyle measures such as early-morning light exposure, vigorous exercise during the day and avoiding caffeine after midday might help a person avoid this difficult dilemma. What Diet Is Best to Reduce Brain Fog? If you want to improve your mood and mental alertness, what diet should you choose? Recently, we spoke with a nutritional psychiatrist who is enthusiastic about a ketogenic diet for treating anxiety or depression. Dr. Naidoo says a thoughtful approach can allow for a keto diet, or a paleo diet, a vegetarian diet or a vegan diet. The keto diet can be effective, but it requires a great deal of attentive management, which may be just too much ...
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    1 h et 1 min
  • Show 1490: Could It Be Parkinson’s? Symptoms People Often Miss

    Show 1490: Could It Be Parkinson’s? Symptoms People Often Miss
    Oct 8 2026
    Neurological conditions have been increasing over the past several decades, but none more quickly than Parkinson disease. What is this disorder, and what is driving the increase? We’ll discuss symptoms people often miss and find out about treatments. At The People’s Pharmacy, we strive to bring you up‑to‑date, rigorously researched insights and conversations about health, medicine, wellness and health policies and health systems. While these conversations intend to offer insight and perspective, the content is provided solely for informational and educational purposes. Please consult your healthcare provider before making any changes to your medical care or treatment. How You Can Listen You could listen through your local public radio station or get the live stream at 7 am EST on Saturday, October 10, 2026, through your computer or smart phone (wvtf.org). Here is a link so you can find which stations carry our broadcast. If you can’t listen to the broadcast, you may wish to hear the podcast later. You can subscribe through your favorite podcast provider, download the mp3 using the link at the bottom of the page, or listen to the stream on this post starting on Oct. 12, 2026. What Is Parkinson Disease? This movement disorder is named after the doctor who first described it in a publication in 1817. As we mentioned, it has become more common in recent years, so you may not be surprised to learn of numerous celebrities who have or have had Parkinson disease (PD). Michael J. Fox may be one of the best known because he has worked so hard to gain recognition that PD can affect people in their 30s and 40s. Of course, like most degenerative conditions, it is more common as people age. Parkinson disease is characterized by a relative lack of dopamine. The areas of the brain that would normally produce this crucial neurotransmitter stop making it, for reasons that are not completely understood. What Dopamine Does We need dopamine for proper functioning with regard to movement, mood, sleep, attention and memory. This explains why some people with PD may experience cognitive challenges or depression. The FDA approved levodopa (AKA L-dopa) in 1970. It is still a mainstay of treatment for Parkinson disease, often with carbidopa. This therapy is more helpful for movement symptoms than for the other aspects of Parkinson disease, however. Symptoms People Often Miss In the past, it wasn’t possible to tell how much dopamine the brain might be making. A person might search for years to get the appropriate diagnosis because symptoms people often miss weren’t noticed. People do think of tremor as a primary symptom of Parkinson disease, but they may confuse it with essential tremor. The tremor of PD occurs when the person is at rest. For example, the hands may shake while lying in the person’s lap. Essential tremor is completely different and occurs while the person is active, such as applying make-up or putting on earrings. Another common symptom of PD is slower motion. It may take longer to cook a meal or get dressed. That is because we need dopamine to move. However, under some circumstances, slow-moving people can move remarkably quickly. Joe has noticed this with a tennis partner, and other people have seen it in emergencies. New technology called DAT spect scan (for dopamine tags) makes it possible to tell if the brain is producing dopamine. The doctor may also order a MRI to make sure that the problem is with the dopamine area of the brain and not caused by a stroke or a tumor. After a diagnosis is established, the doctor may ask the patient to perform toe-tapping and finger-tapping exercises to assess how they are doing. How Do Doctors Treat Parkinson Disease? When we asked our guest, Dr. Nina Browner, what is at the top of her prescription pad for PD patients, she told us it is not a treatment but a conversation. Understanding the person and what is important to them is crucial in guiding the treatment. For example, one of her patients likes to run with his grown sons. This is their way of connecting. For this patient, treatment to maintain mobility is key. High-Intensity Exercise for PD Research, specifically the SPARKS 3 study, has shown that after 17 minutes of vigorous exercise, the brain produces more dopamine. Consequently, the recommendation is to exercise beyond 17 minutes and then stretch to loosen the muscles. For best results, people with PD need much more exercise than other individuals; 30 minutes three times a day provides a good baseline. For even greater efficacy, people might increase their activity up to 150 minutes a day. They can benefit from a wide range of activities, ranging from bicycling to boxing, from tai chi chuan to ping pong, Zumba or dancing. The social aspects of ping pong and Zumba might be especially helpful. Beyond Movement to Symptoms People Often Miss Levodopa, the prescription drug used to replace the missing dopamine, helps improve movement but it does little ...
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    1 h et 20 min
  • Show 1489: The Baby Bust: Why Is Fertility Falling and What Can You Do About It?

    Show 1489: The Baby Bust: Why Is Fertility Falling and What Can You Do About It?
    Sep 30 2026
    Birth rates have been dropping for years. This is happening in many parts of the world, not just the US. Demographers estimate that women need to have 2.1 children, on average, to replace the population. (The US is currently at about 1.7 or 1.8 children per woman.) Where the average number of babies falls below replacement, the country may end up with more elderly people than children. Eventually, this can have economic and social consequences. In this episode, we explore the baby bust. Why is fertility falling? At The People’s Pharmacy, we strive to bring you up to date, rigorously researched insights and conversations about health, medicine, wellness and health policies and health systems. While these conversations intend to offer insight and perspective, the content is provided solely for informational and educational purposes. Please consult your healthcare provider before making any changes to your medical care or treatment. How You Can Listen You could listen through your local public radio station or get the live stream at 7 am EST on Saturday, October 3, 2026, through your computer or smart phone (wunc.org). Here is a link so you can find which stations carry our broadcast. If you can’t listen to the broadcast, you may wish to hear the podcast later. You can subscribe through your favorite podcast provider, download the mp3 using the link at the bottom of the page, or listen to the stream on this post starting on Oct. 5, 2026. Why Is Fertility Falling? Fertility in the US is at a historical low, according to our guest, Dr. Linnea Zimmerman. Whether or not this baby bust constitutes a crisis depends upon your perspective, however. Those who see young people primarily as eager working hands could perceive the economic effects of falling fertility as a future crisis. Others who worry that we are straining the ecological limits of the planet might view a decline in fertility more positively. We asked Dr. Zimmerman about the sources of this baby bust, and she explained that the factors are complex. Although there will almost certainly be some economic consequences of a steep drop in fertility, economic considerations are also important for people considering parenthood. Housing is expensive, and so is childcare. Do they feel confident about their healthcare coverage? It is not clear that the lifetime fertility rate of American women has declined as steeply as the statistics suggest. One good aspect of the current situation is fewer teenage pregnancies. In addition, many women in their 20s, when past generations would have been bearing babies, may be waiting until they feel more settled in their lives, or until they find a suitable partner to raise children with. This can take time. Has Environmental Contamination Affected Fertility? We asked Dr. Zimmerman if we could attribute fertility falling to exposure to environmental factors such as forever chemicals. While PFAS compounds are certainly not good for humans and should be avoided as much as possible, we don’t yet have evidence that they are contributing to a baby bust. What Can You Do About Fertility Challenges? We turned to Dr. Genevieve Neal-Perry to learn about what options people might have if they discover they need help conceiving. According to Dr. Neal-Perry, the available technology has improved greatly over the years, and fertility specialists are frequently able to help a woman conceive and carry the pregnancy to term. Moreover, many more people now have fertility benefits as part of their health insurance. In past years, this was much less common. The source of a fertility challenge is not always obvious. Dr. Neal-Perry suggests that a third of the time, the difficulty lies with the female, a third of the time with the male and a third of the time with the combination. If a woman has endometriosis and is not ovulating, that would need to be addressed first. Men’s fertility begins to drop when they are in their 40s or 50s. Men who take testosterone may have lower sperm counts. In addition, people with very high BMI (40 or above) often have reduced fertility. How Long Should You Wait for Nature to Take its Course? Dr. Neal-Perry suggests that healthy women 35 and under could try for a year before seeking out assistance. Beyond that age, six months is a more realistic time frame. Women who plan to freeze their eggs for future pregnancy should also consider doing this while they are in their mid30s, as they have the best chance of retrieving viable eggs for future use at that age. How Do Medications Affect Conception and Pregnancy? Obstetricians do not recommend that people undertake major weight loss while they are trying to become pregnant. Although there has been some media attention to the phenomenon of “Ozempic babies,” we do not have safety data for GLP-1 agonists such as semaglutide or tirzepatide during pregnancy. In fact, a preconception review of medications a few months before beginning the attempt for a pregnancy ...
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    1 h et 5 min
  • Show 1488: What Can Near-Death Experiences Teach Us About Consciousness?

    Show 1488: What Can Near-Death Experiences Teach Us About Consciousness?
    Sep 25 2026
    After years of dementia, many people have reduced their communication to minimal levels. Sometimes, they don’t say anything at all, and family members may be tempted to assume that memories have disappeared along with cognitive function. Occasionally, such a person will become surprisingly coherent and able to discuss aspects of their lives for a few minutes or even hours. Because they often die within days of such an episode, researchers have termed the phenomenon “terminal lucidity.” Our guest, Dr. Marjorie Woollacott, suggests that the more inclusive term “paradoxical lucidity” might be more appropriate. What do these unexpected events have in common with near-death experiences? Can they teach us about consciousness? At The People’s Pharmacy, we strive to bring you up to date, rigorously researched insights and conversations about health, medicine, wellness and health policies and health systems. While these conversations intend to offer insight and perspective, the content is provided solely for informational and educational purposes. Please consult your healthcare provider before making any changes to your medical care or treatment. How You Can Listen You could listen through your local public radio station or get the live stream at 7 am EST on Saturday, September 26, 2026, through your computer or smart phone (wunc.org). Here is a link [] so you can find which stations carry our broadcast. If you can’t listen to the broadcast, you may wish to hear the podcast later. You can subscribe through your favorite podcast provider, download the mp3 using the link at the bottom of the page, or listen to the stream on this post starting on Sept. 28, 2026. What Is Terminal Lucidity? An article by Billy Brennan in the New York Times Magazine (July 15, 2026) was titled, “Why Do Some Dementia Patients ‘Return’ Just Before They Die?” The subtitle explained, “As they near death, some dementia patients recover mental faculties assumed to be long lost. Researchers want to know why.” We were fascinated by the story Mr. Brennan shares about a conversation with a grandmother a few days before her death. It reminded us of an experience a friend of ours had shared about his own mother. She had dementia and had not communicated much with anyone for a long time. When the nursing home called him and told him she had broken her hip, he expected she would be even more incoherent because of the opioids she would be administered for the pain. So when he arrived at the hospital to find her oriented to time and place and aware of the situation, he was astonished. In this instance, her unexplained clarity continued for a few weeks. We can’t call it “terminal” lucidity, though, as she survived several more years. Such tales suggest that even a disordered brain is not completely lacking in consciousness. But what do we mean by consciousness? A Stroke of Insight to Teach Us About Consciousness Neuroscientists usually assume that the brain creates consciousness, although they haven’t explained exactly how it does so. Some philosophers postulate that consciousness is a fundamental property of the universe. In this view, our brains act as filters so that we don’t become entirely overwhelmed and unable to function. Many years ago, we interviewed Dr. Jill Bolte Taylor, a neuroanatomist, about her brilliant book, My Stroke of Insight. In it, she recounts her own experience and perceptions as she suffered a massive hemorrhagic stroke that affected the left side of her brain. She observed as her brain circuits went offline, one by one. In particular, she was struck by a sense of joy and unity with the entire universe. Our guest for this episode, Dr. Marjorie Woollacott, suggests that during this time, Dr. Bolte Taylor’s stroke removed the usual filters that our brain puts on our consciousness. How Else Might People Have a Different Access to Consciousness? Dr. Woollacott is a meditator as well as a neuroscientist, and she describes her initiation into meditation. To her, it felt as though she were participating in a larger consciousness. Meditation might facilitate a lowering of the filters that usually limit our awareness of a broader consciousness. Dr. Woollacott describes this as a spiritual awakening. Sometimes people describe an experience under the influence of psilocybin in similar terms. Many people who have died and then been revived have described their feelings about such a near-death experience. Dr. Sam Parnia and Dr. Bruce Greyson have both discussed these phenomena for People’s Pharmacy listeners. In such situations, people often accurately depict events that occurred while they were unconscious or technically dead. Most people who have survived a near-death experience consider it a spiritual awakening. They may change their lives from there on. Near Death in a Healthcare Setting Not everyone who undergoes a near-death experience is in a healthcare setting where heart rate (or lack of ...
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    1 h et 5 min
  • Show 1487: Hair Loss and Nail Problems: A Dermatologist’s Guide to What Actually Works

    Show 1487: Hair Loss and Nail Problems: A Dermatologist’s Guide to What Actually Works
    Sep 18 2026
    Do you worry that your hair is thinning? You may wonder what treatments could make a real difference. After all, you wouldn’t want to spend money on something that has no chance of helping. Many people also have concerns about their nails. Perhaps they are ridged, or loose, or too thick. Could that be due to nail fungus, or might it have another cause? Most importantly, what could you do about it? In this episode, you’ll get a dermatologist’s guide to what actually works. At The People’s Pharmacy, we strive to bring you up‑to‑date, rigorously researched insights and conversations about health, medicine, wellness and health policies and health systems. While these conversations intend to offer insight and perspective, the content is provided solely for informational and educational purposes. Please consult your healthcare provider before making any changes to your medical care or treatment. How You Can Listen You could listen through your local public radio station or get the live stream at 7 am EST on Saturday, September 19, 2026, through your computer or smart phone (wunc.org). Here is a link so you can find which stations carry our broadcast. If you can’t listen to the broadcast, you may wish to hear the podcast later. You can subscribe through your favorite podcast provider, download the mp3 using the link at the bottom of the page, or listen to the stream on this post starting on Sept. 21, 2026. What Actually Works for Hair and Nail Problems Dr. Chris Adigun practices both general and cosmetic dermatology. We wanted to ask her about nail problems in particular because they are very common and she maintains a specialty in treating them. We asked her about the most common nail problems she sees, and she named simple onycholysis (pronounced Oh-nick-oh-LYE-sis). In this condition, the nail begins to lift away from the nail bed. You can identify it because the white area at the fingertip becomes much more extensive than usual. Usually, this is due to exposure to acids such as citrus juices or cleaning solutions. Having your hands in and out of irritants or even water (with or without soap) could lead to onycholysis. An overactive thyroid gland could also lead to onycholysis. To prevent it, try to avoid putting your hands into that sort of liquid. If you must do so, use gloves. And of course, a good hand cream to bolster the skin barrier is a very good idea. If these approaches don’t do the trick, especially if there are other symptoms, the doctor may want to test for thyroid function. Another common problem is allergic contact dermatitis. This could be caused by some of the same irritating substances responsible for onycholysis, but cosmetics are common culprits here. Nail polish and remover, especially nail polish remover, can cause nail problems for some people. If you are one of them, what actually works best might mean finding a less irritating product or, even better, leaving the nails unadorned. White Spots on Nails Many people have noticed white spots on their nails. We asked Dr. Adigun what causes these, and she replied that usually they are not worrisome. If you bang your fingertip, as you might if you slammed it in a door or a drawer, the trauma may show up several weeks later as a white spot. (More serious trauma could show up as a dark spot due to blood pooling under the nail; we discussed that with podiatrist Jane Anderson here, but not with Dr. Adigun.) What About Ridges on the Nails? Nail ridges are very common, and the ones that run lengthwise along the same axis as the finger are due to aging. Just as our skin develops wrinkles, so do our nails. Consequently, there are no effective treatments. Nail ridges in children are a different story. They might show up as nails having the texture of sandpaper, or they could be horizontal ridges. Such nails should be seen by a physician, as they could signal an inflammatory condition called lichen planus or even an early sign of psoriasis. While we don’t have cures for these conditions, there are effective medications to manage them. Hangnails and Cuticle Problems Are you surprised that dermatologists have a fancy term to describe cuticle problems and other trouble affecting the skin around the nail? They call it paronychia (PEAR-oh-nick-ee-ya). If it is caused by an infection, it might be treated with an antimicrobial compound. The best preventative is not to pull, bite or clip off hangnails or rough spots in the cuticles, the skin near the nails. Instead, moisturize and possibly cover the spot with a bandage to remove the temptation while it softens and heals. Instant glue is another simple remedy that really works for hangnails. Treating Nail Fungus When the nails are thick, ugly and hard to trim, often people blame nail fungus. But surprisingly, it isn’t always the culprit. Mechanical trauma can also create thick nails that are hard to cut. If the nail is thick because it is on a hammer toe so it bumps against the insole...
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    1 h et 15 min
  • Show 1486: Sprains, Strains and Tears: The New Science of Healing Faster

    Show 1486: Sprains, Strains and Tears: The New Science of Healing Faster
    Sep 10 2026
    For years, anyone who sprained an ankle or twisted a knee got some standard advice: ice it, rest it, wrap it with compression tape and keep it elevated. The acronym for Rest, Ice, Compress and Elevate is RICE. New research shows that following this advice alleviates the pain from the injury in the short term, but it may actually slow healing. What can help you in healing faster from this type of problem? You can hear it directly from a scientist applying cutting-edge research with tendons and rats to getting NBA players back on the court sooner. At The People’s Pharmacy, we strive to bring you up to date, rigorously researched insights and conversations about health, medicine, wellness and health policies and health systems. While these conversations intend to offer insight and perspective, the content is provided solely for informational and educational purposes. Please consult your healthcare provider before making any changes to your medical care or treatment. How You Can Listen You could listen through your local public radio station or get the live stream at 7 am EST on Saturday, September 12, 2026, through your computer or smart phone (wunc.org). Here is a link so you can find which stations carry our broadcast. If you can’t listen to the broadcast, you may wish to hear the podcast later. You can subscribe through your favorite podcast provider, download the mp3 using the link at the bottom of the page, or listen to the audio stream on this post starting on Sept. 14, 2026. We will also be putting up a YouTube video podcast so you can watch our guest do some demonstrating. Healing Faster from Injuries Sports medicine expert Dr. Gabe Mirkin coined the acronym RICE in the 1970s. At the time, many physicians and physical therapists embraced this approach to treating injuries. It helped reduce the pain in the immediate term, and it doesn’t seem to do any harm over the longer term. It can take quite a while to heal damaged tendons and ligaments, however. Sometimes, that takes even longer than for broken bones to knit. Eventually, Dr. Mirkin reversed his RICE recommendation. But very few professionals took note. Is there a happy medium between applying RICE and toughing it out by trying to walk a sprained ankle off? Our guest on this episode has been studying the topic of healing faster from injuries and has some concrete advice to offer. Trying to Fool Mother Nature Many of the precautions that amateur athletes take are designed to undermine the body’s inflammatory response. Yet acute inflammation is exactly how the body tries to heal itself from injury. Ice and ibuprofen are anti-inflammatory, so taking ibuprofen before exercise or icing a sore knee afterwards might be counterproductive. What Is a Better Approach to Healing Faster? According to Dr. Keith Baar, immobilizing a joint (“rest”) leads quickly to loss of muscle and force. When he put rats on bed rest (listen to learn how), they lost strength rapidly. On the other hand, moving a joint gently helps to reduce swelling by pumping fluid out. This, in turn, is an early step in healing faster. How do you move a joint gently? Dr. Baar has developed his own acronym: 3LD isometrics. How Do You Practice 3LD Isometrics? First of all, what does 3LD even mean? It stands for low-load, long-duration isometrics. During isometric exercise, instead of moving a muscle quickly, you hold it in position until it fatigues. Physical therapists recommend isometrics, such as planks or wall squats, to strengthen the muscles around joints. In low-load long-duration exercises, you provide some support so you are not putting your entire body weight on the joint. In other words, you lessen the load. Rather than moving quickly through the motion, you find the point at which you can feel the tension in the muscle but it doesn’t actually hurt. Dr. Baar describes this as ooh instead of ouch. Then you hold that position (with the support, remember) for 30 seconds or so. This is a relatively long duration. Healing Faster from Sports Injuries Dr. Baar describes how he helped his nephew, a college-team football linebacker, heal an injured shoulder. Sports injuries are not the only joint problems that could benefit from healing faster with 3LD isometrics. Other common complaints are carpal tunnel syndrome in the wrist or plantar fasciitis in the foot. Changing the Culture of Treating Injury Dr. Baar describes his work with a rugby player who injured his hamstring tendon and was able to resume playing much earlier than the surgeon initially anticipated. Baar’s team has also worked with a basketball player who ruptured an Achilles tendon last year. Healing faster with 3LD isometric work got him back on the court last year–the only NBA player with such an injury to manage that. As elite athletes learn the advantages of 3LD isometrics, physical therapists will begin offering it to ordinary people who simply want to resume their usual activities sooner. This Week’...
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    1 h et 5 min
  • Show 1421: Is Lp(a) the Heart Risk No One Talks About? (Archive)

    Show 1421: Is Lp(a) the Heart Risk No One Talks About? (Archive)
    Sep 3 2026
    This week, we get in-depth information on Lp(a), the heart risk no one talks about. You have heard of cholesterol, and you may even know what your cholesterol level is. The compound lipoprotein a may be equally dangerous when it is elevated, but you have probably heard very little about it. At The People’s Pharmacy, we strive to bring you up‑to‑date, rigorously researched insights and conversations about health, medicine, wellness and health policies and health systems. While these conversations intend to offer insight and perspective, the content is provided solely for informational and educational purposes. Please consult your healthcare provider before making any changes to your medical care or treatment. How You Can Listen You could listen through your local public radio station on Sept. 5, 2026, or get the live stream at 7 am EDT on your computer or smart phone (wunc.org). Here is a link so you can find which stations carry our broadcast. If you can’t listen to the broadcast, you may wish to hear the podcast later. You can subscribe through your favorite podcast provider, download the mp3 using the link at the bottom of the page, or listen to the stream on this post starting on Sept. 7, 2026. What Is Lp(a)? Lipoprotein a, or L-P-little a for short, circulates in the bloodstream, where it picks up and carries cholesterol and oxidized phospholipids. Scientists believe that blood levels are determined mostly by genetics and change very little over the course of our lives. Roughly 20 percent of people have high levels of Lp(a), above 30 ng/dL or 75 nmol/L. The two different figures are because tests use different units to measure the blood concentration, either nanograms per deciliter or nanomols per liter. While we don’t know if Lp(a) has or perhaps once had some important functions, we do know that elevated levels of this chemical is associated with heart disease. People with higher levels are more likely to suffer blood clots and inflammation. That puts them at risk for heart attacks or even strokes. So why hasn’t your doctor ordered a blood test to learn your level? Is Lp(a) the Heart Risk Doctors Can’t Treat? Perhaps doctors have been reluctant to measure or discuss lipoprotein a because they don’t have good interventions. That is beginning to change with the development of antisense oligonucleotides, a new category of prescription drugs that can cut levels sharply. The FDA has not yet approved any of these new medications, though. The first of these, pelacarsen, is still in Phase 3 trials needed before the agency can consider the evidence. However, it can bring down lipoprotein a by an estimated 80 percent. Cardiologists’ favorite drugs, statins, do not help Lp(a) levels. In fact, Lp(a) the heart risk rises when people are taking statins to lower their cholesterol. Other cholesterol-lowering drugs such as evolocumab (Repatha) and alirocumab (Praluent) can bring Lp(a) levels down modestly. One really old cholesterol-lowering drug, high-dose niacin, also helps moderate Lp(a). Some people do not tolerate it, however, as it can cause very uncomfortable flushing. So far as we know, no scientists have run studies to see whether niacin reduces the risk of heart attacks and other complications because of its effects on Lp(a). Other Complications of Lp(a): Our guest, Dr. Sam Tsimikas, is among the country’s leading experts on lipoprotein a. We asked him whether Lp(a) the heart risk factor causes other problems as well. Dr. Tsimikas described heart failure, potentially resulting from a heart attack, as well as peripheral artery disease (PAD), which can make it painful to walk. Lp(a) seems to cause plaque in arteries throughout the body. As a result, it can increase the chance of a stroke. In addition, it contributes to calcification of the heart valves. This condition interferes with their ability to function properly. What Can We Do If Lp(a) Is Too High? Dr. Tsimikas runs a unique clinic for cardiology patients with high levels of Lp(a). We asked him how he helps them. One approach is to collect additional information about their level of risk. A coronary calcium score can be a useful indicator. If it is high, he and his patients work to control all the potential risk factors that they can. He discusses the potential benefit of aspirin with them. Because Lp(a) the heart risk factor increases the chance of dangerous blood clots, the anti-clotting activity of aspirin can sometimes be helpful. Offering dietary advice can be tricky if a patient has high cholesterol as well as elevated Lp(a), since the ideal diets for each are nearly opposite each other. A ketogenic diet tends to raise LDL cholesterol, for example, while it may modestly lower Lp(a). We think by the end of this episode, you’ll join us in hoping that scientists can learn a lot more about Lp(a) in the next few years. This Week’s Guest: Sotirios (Sam) Tsimikas, MD, FACC, FAHA, FSCAI, is Professor of Medicine/Cardiology and...
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